Provider Demographics
NPI:1336039858
Name:FULL DESTINY COUNSELING, LLC
Entity type:Organization
Organization Name:FULL DESTINY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:W
Authorized Official - Last Name:PRUNTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-919-8904
Mailing Address - Street 1:719 BRODERICK CIR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2415
Mailing Address - Country:US
Mailing Address - Phone:478-919-8904
Mailing Address - Fax:844-853-5737
Practice Address - Street 1:101 KATELYN CIR STE C
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-6484
Practice Address - Country:US
Practice Address - Phone:678-664-8742
Practice Address - Fax:844-853-5737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty