Provider Demographics
NPI:1962824466
Name:ICAN THINK POSITIVE COUNSELING AND COACHING SERVICES
Entity Type:Organization
Organization Name:ICAN THINK POSITIVE COUNSELING AND COACHING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-256-0099
Mailing Address - Street 1:PO BOX 165
Mailing Address - Street 2:
Mailing Address - City:REDAN
Mailing Address - State:GA
Mailing Address - Zip Code:30074-0165
Mailing Address - Country:US
Mailing Address - Phone:678-999-2611
Mailing Address - Fax:
Practice Address - Street 1:5405 MEMORIAL DR BLDG C
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3234
Practice Address - Country:US
Practice Address - Phone:678-999-2611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health