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Organization
NEVAEH CONSULTING, LLC
Active
Organization
NEVAEH CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEWAYNE GRANT LPC (CEO/THERAPIST)
(678) 215-8705
Entity
Organization
Contact information
Practice address
124 S MAIN ST, JONESBORO, GA 30236-3599
(678) 215-8705
(770) 898-4385
Mailing address
417 AKERS DR, MCDONOUGH, GA 30253-8382
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003152990A
—
GA
Enumeration date
11/09/2016
Last updated
11/09/2016
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