| Lifespan Counseling Of Atlanta, Llc | |
|
1924 Clairmont Rd Ste 105 Decatur GA 30033-3438 | |
| (678) 907-3106 | |
| Not Available |
| Full Name | Lifespan Counseling Of Atlanta, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1924 Clairmont Rd Ste 105, Decatur, Georgia |
| Authorized Official Name and Position | Elizabeth Natalie Valera (SOLE OWNER/MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 6789073106 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Counseling Of Atlanta, Llc 3201 Oakbrook Ln Clarkston GA 30021-1004 Ph: (678) 907-3106 | Lifespan Counseling Of Atlanta, Llc 1924 Clairmont Rd Ste 105 Decatur GA 30033-3438 Ph: (678) 907-3106 |
| NPI Number | 1144096710 |
|---|---|
| Provider Enumeration Date | 11/27/2023 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/26/2023 |
| Medicare PECOS PAC ID | 7416306113 |
|---|---|
| Medicare Enrollment ID | O20231206002807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144096710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Natalie Valera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811495963 PECOS PAC ID: 8325497027 Enrollment ID: I20231206003236 |
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