Healing Transitions Counseling Center | |
5165 Lavista Rd Tucker GA 30084-3602 | |
(770) 908-1746 | |
Not Available |
Full Name | Healing Transitions Counseling Center |
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Speciality | Social Worker |
Location | 5165 Lavista Rd, Tucker, Georgia |
Authorized Official Name and Position | Nancy F Penn (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 7709081746 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Healing Transitions Counseling Center 4378 Sleepy Hollow Cv Lilburn GA 30047-4196 Ph: () - | Healing Transitions Counseling Center 5165 Lavista Rd Tucker GA 30084-3602 Ph: (770) 908-1746 |
NPI Number | 1023255684 |
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Provider Enumeration Date | 01/19/2009 |
Last Update Date | 01/19/2009 |
Medicare PECOS PAC ID | 0244643112 |
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Medicare Enrollment ID | O20210114000267 |
Identifier | Type | State | Issuer |
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1023255684 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | CSW002606 (Georgia) | Primary |
Provider Name | Nancy F Penn |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1053479113 PECOS PAC ID: 6800999186 Enrollment ID: I20070306000497 |
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