Individual
THELSEA SCOTT RAYMONVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5246 CINDY WAY, STONE MOUNTAIN, GA 30083-3692
(334) 453-8267
Mailing address
1445 WOODMONT LN NW STE 3762, ATLANTA, GA 30318-2866
(334) 453-8267
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC014056
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC014056
GA
101YM0800X
Mental Health Counselor
LPC014056
GA
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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