Provider Demographics
NPI:1659795367
Name:PRELUDE COUNSELING CENTERS INTL., INC.
Entity Type:Organization
Organization Name:PRELUDE COUNSELING CENTERS INTL., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONEE
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:MERRIWEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:678-665-2562
Mailing Address - Street 1:PO BOX 874
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-0016
Mailing Address - Country:US
Mailing Address - Phone:678-665-2562
Mailing Address - Fax:866-269-4084
Practice Address - Street 1:1509 ATKINSON RD
Practice Address - Street 2:SUITE 2200
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-7986
Practice Address - Country:US
Practice Address - Phone:678-665-2562
Practice Address - Fax:866-269-4084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004470101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty