Organization
DYNAMIC CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDRA THOMAS LPC, CRC (OWNER/ THERAPIST)
(470) 347-6896
Entity
Organization
Contact information
Practice address
2255 CUMBERLAND PKWY SE STE 240, ATLANTA, GA 30339-4515
(470) 347-6896
Mailing address
1102 WESTCHASE LN SW APT 910, ATLANTA, GA 30336-4427
(404) 274-7408
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
10/11/2020
Last updated
10/11/2020
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