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Organization

MASTER PLAN CHRISTIAN COUNSELING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHARON J IVY (PASTORAL COUNSELOR)
(773) 241-4861
Entity
Organization

Contact information

Practice address
133 JOHNSON FERRY RD, SUITE 110, MARIETTA, GA 30068-4923
(773) 241-4861
(678) 504-5590
Mailing address
3632 RIVER HEIGHTS XING SE, MARIETTA, GA 30067-4870
(773) 241-4861
(678) 504-5590

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
02125023
GA
251S00000X
Community/Behavioral Health Agency
Primary
02127178
GA

Other

Enumeration date
06/20/2012
Last updated
06/20/2012
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