Provider Demographics
NPI:1124912662
Name:GRACEFUL SERENITY COUNSELING LLC
Entity type:Organization
Organization Name:GRACEFUL SERENITY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC NCC
Authorized Official - Phone:678-807-9594
Mailing Address - Street 1:898 SWEET BRIAR TRL SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-3854
Mailing Address - Country:US
Mailing Address - Phone:347-346-0156
Mailing Address - Fax:
Practice Address - Street 1:1775 PARKER RD SE STE 210
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6654
Practice Address - Country:US
Practice Address - Phone:678-807-9594
Practice Address - Fax:470-974-2175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty