Provider Demographics
NPI:1508482993
Name:POSITIVE INFLUENCES COUNSELING LLC
Entity Type:Organization
Organization Name:POSITIVE INFLUENCES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHALEE
Authorized Official - Middle Name:NOTAYA
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-770-6034
Mailing Address - Street 1:195 W PIKE ST STE 104
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4966
Mailing Address - Country:US
Mailing Address - Phone:678-770-6034
Mailing Address - Fax:678-804-4708
Practice Address - Street 1:195 W PIKE ST STE 104
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4966
Practice Address - Country:US
Practice Address - Phone:404-436-6664
Practice Address - Fax:678-804-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty