Organization
IDALUZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IOLANDA L DA LUZ LPC, NCC, LPCA (MENTAL HEALTH PROFESSIONAL)
(401) 588-0121
Entity
Organization
Contact information
Practice address
1869 S CARISBROOK PL, AUSTELL, GA 30168-5147
(401) 588-0121
Mailing address
1869 S CARISBROOK PL, AUSTELL, GA 30168-5147
(401) 588-0121
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
102L00000X
Psychoanalyst
—
—
106H00000X
Marriage & Family Therapist
—
—
171400000X
Health & Wellness Coach
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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