Provider Demographics
NPI:1649741174
Name:GOOD LIFE COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:GOOD LIFE COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:201-704-5585
Mailing Address - Street 1:1151 AUGUSTINE DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30011-3097
Mailing Address - Country:US
Mailing Address - Phone:201-704-5585
Mailing Address - Fax:
Practice Address - Street 1:1585 OLD NORCROSS RD STE 204D
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4043
Practice Address - Country:US
Practice Address - Phone:678-963-2725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty