| Fortitude2grow Counseling & Consulting, LLC | |
|
170 Brookstone Crst Newnan GA 30265-2270 | |
| (678) 877-1730 | |
| Not Available |
| Full Name | Fortitude2grow Counseling & Consulting, LLC |
|---|---|
| Speciality | Counselor |
| Location | 170 Brookstone Crst, Newnan, Georgia |
| Authorized Official Name and Position | Waikiki L Upshaw (OWNER) |
| Authorized Official Contact | 6788771395 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fortitude2grow Counseling & Consulting, LLC 90f Glenda Trce Ste 236 Newnan GA 30265-3858 Ph: (678) 877-1730 | Fortitude2grow Counseling & Consulting, LLC 170 Brookstone Crst Newnan GA 30265-2270 Ph: (678) 877-1730 |
| NPI Number | 1447078548 |
|---|---|
| Provider Enumeration Date | 09/28/2024 |
| Last Update Date | 09/28/2024 |
| Certification Date | 09/28/2024 |
| Medicare PECOS PAC ID | 4284143678 |
|---|---|
| Medicare Enrollment ID | O20250605002299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447078548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Waikiki L Upshaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942432885 PECOS PAC ID: 6305378845 Enrollment ID: I20241022002381 |
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