| Im Legacy Counseling & Consultation Services, Llc | |
|
3562 Piedmont Rd Ne Apt 305 Atlanta GA 30305-7003 | |
| (614) 206-4452 | |
| Not Available |
| Full Name | Im Legacy Counseling & Consultation Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3562 Piedmont Rd Ne Apt 305, Atlanta, Georgia |
| Authorized Official Name and Position | Vaya Milan Fraley (CO-FOUNDER) |
| Authorized Official Contact | 6147061899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Im Legacy Counseling & Consultation Services, Llc 3737 Easton Market Unit 1201 Columbus OH 43219-6023 Ph: (614) 706-1899 | Im Legacy Counseling & Consultation Services, Llc 3562 Piedmont Rd Ne Apt 305 Atlanta GA 30305-7003 Ph: (614) 206-4452 |
| NPI Number | 1609519701 |
|---|---|
| Provider Enumeration Date | 04/16/2022 |
| Last Update Date | 04/16/2022 |
| Certification Date | 04/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609519701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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