Organization
DESTINATION GREATNESS-GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNA AMANDA JEFFERSON (CEO)
(800) 647-3345
Entity
Organization
Contact information
Practice address
3343 PEACHTREE RD NE STE 145-1058, ATLANTA, GA 30326-1085
(800) 647-3345
(866) 923-0754
Mailing address
PO BOX 29144, ATLANTA, GA 30359-0144
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/03/2016
Last updated
02/10/2021
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