Provider Demographics
NPI:1932718962
Name:ABUNDANT HEALING PASTORAL COUNSELING
Entity Type:Organization
Organization Name:ABUNDANT HEALING PASTORAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PASTORAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NYABINGHI
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:770-779-7927
Mailing Address - Street 1:107 ENTERPRISE PATH STE 306-2A
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2689
Mailing Address - Country:US
Mailing Address - Phone:770-779-8927
Mailing Address - Fax:678-807-5415
Practice Address - Street 1:107 ENTERPRISE PATH STE 306-2A
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2689
Practice Address - Country:US
Practice Address - Phone:770-779-8927
Practice Address - Fax:678-807-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty