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Organization
YOUR WAY OUT, LLC
Active
Organization
YOUR WAY OUT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE BROOKE STARKS LPC (OWNER)
(404) 285-9259
Entity
Organization
Contact information
Practice address
2330 SCENIC HWY S STE 316, SNELLVILLE, GA 30078-3115
(404) 500-6924
(404) 393-4696
Mailing address
2330 SCENIC HWY S STE 316, SNELLVILLE, GA 30078-3115
(404) 500-6924
(404) 393-4696
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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