Organization
KALEIDOSOUL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY NICOLE PAXTON LPC, CAMS,CMAC (OWNER)
(785) 456-6926
Entity
Organization
Contact information
Practice address
220 LANIER AVE E STE 7, FAYETTEVILLE, GA 30214-1604
(678) 545-6692
(678) 519-5673
Mailing address
220 LANIER AVE E STE 7, FAYETTEVILLE, GA 30214-1604
(678) 545-6692
(678) 519-5673
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
09/21/2022
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