Organization
CONSCIOUS RENEWING THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEKEYA BLAKE DSW, LCSW (OWNER)
(470) 263-6320
Entity
Organization
Contact information
Practice address
3100 STONE BRIDGE TRL SW, CONYERS, GA 30094-6713
(470) 263-6320
Mailing address
3863 HIGHWAY 138 SE # 1379, STOCKBRIDGE, GA 30281-4143
(470) 263-7264
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
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