Organization Name: | FOREVER CHANGED COUNSELING, INC |
NPI Number: | 1003273632 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RENEE WILLIS (CEO/OWNER) |
Mailing Address: | 109 Central Ave Cartersville |
State: | GA US |
Postal Code: | 301203905 |
Phone Number: | 6572290679 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2016 |
NPI Last Update Date: | 01/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC008460 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |