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Organization
TRANQUIL LIFE COUNSELING CENTER, LLC
Active
Organization
TRANQUIL LIFE COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KOALENZ LPC (OWNER)
(678) 896-8959
Entity
Organization
Contact information
Practice address
1899 LAKE RD STE 123, HIRAM, GA 30141-6006
(678) 896-8959
(678) 550-1155
Mailing address
1899 LAKE RD STE 123, HIRAM, GA 30141-6006
(678) 896-8959
(678) 550-1155
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/31/2017
Last updated
04/29/2024
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