| Samuels Holistic Counseling Services Llc | |
|
224 Arrowhead Blvd Ste 101 Jonesboro GA 30236-1113 | |
| (770) 893-8044 | |
| Not Available |
| Full Name | Samuels Holistic Counseling Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 224 Arrowhead Blvd Ste 101, Jonesboro, Georgia |
| Authorized Official Name and Position | Terry Samuels (OWNER) |
| Authorized Official Contact | 7708938044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuels Holistic Counseling Services Llc 224 Arrowhead Blvd Ste 101 Jonesboro GA 30236-1113 Ph: () - | Samuels Holistic Counseling Services Llc 224 Arrowhead Blvd Ste 101 Jonesboro GA 30236-1113 Ph: (770) 893-8044 |
| NPI Number | 1316779564 |
|---|---|
| Provider Enumeration Date | 08/16/2024 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Medicare PECOS PAC ID | 5698200368 |
|---|---|
| Medicare Enrollment ID | O20241119002008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316779564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tabitha T Samuels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851081343 PECOS PAC ID: 9234664905 Enrollment ID: I20241119001981 |
| Provider Name | Terry Samuels |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649720913 PECOS PAC ID: 7315472081 Enrollment ID: I20241119002205 |
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