Provider Demographics
NPI:1053726158
Name:KEYS TO A HEALTHY RELATIONSHIP,LLC
Entity type:Organization
Organization Name:KEYS TO A HEALTHY RELATIONSHIP,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,NCC
Authorized Official - Phone:404-664-0881
Mailing Address - Street 1:997 COMMERCE DR SW
Mailing Address - Street 2:SUITE3E
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6647
Mailing Address - Country:US
Mailing Address - Phone:404-664-0881
Mailing Address - Fax:800-449-1093
Practice Address - Street 1:997 COMMERCE DR SW
Practice Address - Street 2:SUITE3E
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6647
Practice Address - Country:US
Practice Address - Phone:404-664-0881
Practice Address - Fax:800-449-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007815251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2295450OtherCOMPSYCH