Organization
ONE-EIGHTY COUNSELING PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEANA JO VIVIAN LPC (THERAPIST)
(678) 836-9263
Entity
Organization
Contact information
Practice address
1003 VIRGINIA AVE STE 212, ATLANTA, GA 30354-1387
(678) 836-9263
(678) 927-9355
Mailing address
PO BOX 82567, ATLANTA, GA 30354-0567
(678) 836-9263
(678) 927-9355
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LPC009559
GA
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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