Provider Demographics
NPI:1538632476
Name:GIFTED COUNSELING
Entity type:Organization
Organization Name:GIFTED COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-496-8070
Mailing Address - Street 1:303 PERIMETER CTR N STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-3401
Mailing Address - Country:US
Mailing Address - Phone:404-496-8070
Mailing Address - Fax:
Practice Address - Street 1:303 PERIMETER CTR N STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-3401
Practice Address - Country:US
Practice Address - Phone:404-496-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty