Provider Demographics
NPI:1356029268
Name:POISED PERSEVERANCE LLC
Entity type:Organization
Organization Name:POISED PERSEVERANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GELFAND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:718-662-8034
Mailing Address - Street 1:170 MIRRAMONT LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-8183
Mailing Address - Country:US
Mailing Address - Phone:770-953-4640
Mailing Address - Fax:
Practice Address - Street 1:1827 POWERS FERRY RD SE BLDG 22
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5621
Practice Address - Country:US
Practice Address - Phone:770-953-4640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty