Organization
HER WELLNESS CIRCLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EBONY PETERSON LCSW (OWNER)
(678) 538-9614
Entity
Organization
Contact information
Practice address
3605 SANDY PLAINS RD STE 493, MARIETTA, GA 30066-3068
(678) 538-9614
(678) 538-9613
Mailing address
3605 SANDY PLAINS RD STE 493, MARIETTA, GA 30066-3068
(678) 538-9614
(678) 538-9613
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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