| Peaceful Insight Counseling Llc | |
|
220 Corporate Center Dr Ste C Stockbridge GA 30281-6312 | |
| (678) 478-2937 | |
| Not Available |
| Full Name | Peaceful Insight Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 220 Corporate Center Dr Ste C, Stockbridge, Georgia |
| Authorized Official Name and Position | Devesea Tatum (OWNER) |
| Authorized Official Contact | 6782017948 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peaceful Insight Counseling Llc 220 Corporate Center Dr Ste C Stockbridge GA 30281-6312 Ph: (678) 478-2937 | Peaceful Insight Counseling Llc 220 Corporate Center Dr Ste C Stockbridge GA 30281-6312 Ph: (678) 478-2937 |
| NPI Number | 1194364075 |
|---|---|
| Provider Enumeration Date | 12/25/2019 |
| Last Update Date | 10/26/2021 |
| Certification Date | 10/26/2021 |
| Medicare PECOS PAC ID | 7214368240 |
|---|---|
| Medicare Enrollment ID | O20200507001273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194364075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Devesea Tatum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023417565 PECOS PAC ID: 1658612536 Enrollment ID: I20190402001100 |
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