Provider Demographics
NPI:1952024085
Name:PRELUDE MENTAL HEALTH COUNSELING, LLC
Entity Type:Organization
Organization Name:PRELUDE MENTAL HEALTH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC SINGLE MEMBER/SERVICE PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:KALAFUT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-671-2520
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:VARNELL
Mailing Address - State:GA
Mailing Address - Zip Code:30756-0361
Mailing Address - Country:US
Mailing Address - Phone:706-671-2520
Mailing Address - Fax:706-671-2590
Practice Address - Street 1:313 N SELVIDGE ST STE 107
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3156
Practice Address - Country:US
Practice Address - Phone:706-671-2520
Practice Address - Fax:706-671-2590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health