Organization
OPERATION STREET HARVEST, INC. DBA GA BLACK LICENSED ASSOC. COUNSELORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONYA LYNN SUMNER BROWN PYSD., LPC, M.DIV. (CEO/CLINICAL SUPERVISOR/PRESIDENT)
(678) 978-9391
Entity
Organization
Contact information
Practice address
1 W COURT SQ STE 750, DECATUR, GA 30030-2538
(678) 978-9391
(770) 538-1716
Mailing address
3982 MISTY LK, ELLENWOOD, GA 30294-1164
(678) 978-9391
(770) 538-1716
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
03/11/2024
Last updated
03/28/2024
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