Provider Demographics
NPI:1700108941
Name:PERSONAL COACHING & PSYCHOTHERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PERSONAL COACHING & PSYCHOTHERAPY ASSOCIATES, LLC
Other - Org Name:PERSONAL COACHING & PSYCHOTHERAPY FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARGE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, NCC, DCC
Authorized Official - Phone:678-230-8127
Mailing Address - Street 1:175 PINE GROVE RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-8483
Mailing Address - Country:US
Mailing Address - Phone:678-230-8127
Mailing Address - Fax:
Practice Address - Street 1:175 PINE GROVE RD
Practice Address - Street 2:SUITE 125
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-8483
Practice Address - Country:US
Practice Address - Phone:678-230-8127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005264101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty