# REVIVE COUNSELING & CONSULTING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336558204
- **Authorized official:** LAUREN BAKER M.A., LMFT, LPC (OWNER/ THERAPIST)
- **Authorized official phone:** (404) 590-6005

## Contact information

- **Practice address:** 750 HAMMOND DR, BUILDING 4, SUITE 300, ATLANTA, GA 30328-5532
- **Practice address phone:** (404) 590-6005
- **Mailing address:** 750 HAMMOND DR, BUILDING 4, SUITE 300, ATLANTA, GA 30328-5532
- **Mailing address phone:** (404) 590-6005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | LPC007169 | GA | — |
| 106H00000X | Marriage & Family Therapist | MFT001272 | GA | Yes |

## Other

- **Enumeration date:** 08/05/2014
- **Last updated:** 08/05/2014