Organization
LIFE CHANGES COUNSELING AND CONSULTANT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERENCE WILKINS LPC, MAC (CEO)
(609) 743-1773
Entity
Organization
Contact information
Practice address
1003 VIRGINIA AVE STE 104, ATLANTA, GA 30354-1366
(404) 500-1994
Mailing address
1003 VIRGINIA AVE STE 104, ATLANTA, GA 30354-1366
(404) 500-1994
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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