Provider Demographics
NPI:1598032146
Name:A HEALING JOURNEY COUNSELING & CONSULTATION
Entity Type:Organization
Organization Name:A HEALING JOURNEY COUNSELING & CONSULTATION
Other - Org Name:PAMELA A. BRIDGEMAN
Other - Org Type:Other Name
Authorized Official - Title/Position:THERAPIST/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRIDGEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-983-4444
Mailing Address - Street 1:PO BOX 2603
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-1694
Mailing Address - Country:US
Mailing Address - Phone:770-983-4444
Mailing Address - Fax:770-334-2739
Practice Address - Street 1:109 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3905
Practice Address - Country:US
Practice Address - Phone:770-983-4444
Practice Address - Fax:770-383-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0044831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty