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Organization
OPERATION STREET HARVEST, INC. DBA GA BLACK LICENSED ASSOC. COUNSELORS
Active
Organization
OPERATION STREET HARVEST, INC. DBA GA BLACK LICENSED ASSOC. COUNSELORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONYA LYNN SUMNER BROWN PYSD., LPC, M.DIV. (CEO/CLINICAL SUPERVISOR/PRESIDENT)
(678) 978-9391
Entity
Organization
Contact information
Practice address
1 W COURT SQ STE 750, DECATUR, GA 30030-2538
(678) 978-9391
(770) 538-1716
Mailing address
3982 MISTY LK, ELLENWOOD, GA 30294-1164
(678) 978-9391
(770) 538-1716
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
03/11/2024
Last updated
03/28/2024
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