Provider Demographics
NPI:1134589294
Name:PEACEMAKER SOLUTIONS, INC.
Entity type:Organization
Organization Name:PEACEMAKER SOLUTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUSELU
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, LPC, CPCS
Authorized Official - Phone:404-644-5523
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-0042
Mailing Address - Country:US
Mailing Address - Phone:678-582-1469
Mailing Address - Fax:770-212-2210
Practice Address - Street 1:1827 BRACKENDALE RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7747
Practice Address - Country:US
Practice Address - Phone:678-582-1469
Practice Address - Fax:770-212-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X
GALPC008829251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty