Provider Demographics
NPI:1740618750
Name:HOLISTIC THERAPEUTIC COUNSELING, LLC
Entity Type:Organization
Organization Name:HOLISTIC THERAPEUTIC COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-754-4128
Mailing Address - Street 1:PO BOX 54051
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-0051
Mailing Address - Country:US
Mailing Address - Phone:404-754-4128
Mailing Address - Fax:404-745-0330
Practice Address - Street 1:250 GEORGIA AVE SE
Practice Address - Street 2:SUITE 310
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-3046
Practice Address - Country:US
Practice Address - Phone:404-754-4128
Practice Address - Fax:404-745-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW004962251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health