Provider Demographics
NPI:1760006035
Name:HEALTHY CONNECTIONS COUNSELING
Entity type:Organization
Organization Name:HEALTHY CONNECTIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-810-2057
Mailing Address - Street 1:4434 COLUMBIA RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4271
Mailing Address - Country:US
Mailing Address - Phone:706-810-2057
Mailing Address - Fax:706-810-2057
Practice Address - Street 1:4434 COLUMBIA RD STE 202
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-4271
Practice Address - Country:US
Practice Address - Phone:706-810-2057
Practice Address - Fax:706-810-2057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003222181AMedicaid