Provider Demographics
NPI:1932727021
Name:GREATER PATH COUNSELING
Entity Type:Organization
Organization Name:GREATER PATH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:470-701-4995
Mailing Address - Street 1:3763 JONATHAN GLEN WAY SW
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-4143
Mailing Address - Country:US
Mailing Address - Phone:470-701-4995
Mailing Address - Fax:
Practice Address - Street 1:3763 JONATHAN GLEN WAY SW
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039
Practice Address - Country:US
Practice Address - Phone:470-701-4995
Practice Address - Fax:470-998-2106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003205595CMedicaid