Provider Demographics
NPI:1053729194
Name:COUNSELING4LIFE, LLC
Entity type:Organization
Organization Name:COUNSELING4LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:LAMPERT
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, RN, LPC
Authorized Official - Phone:404-580-8846
Mailing Address - Street 1:670 POWERS FERRY NORTH SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-7190
Mailing Address - Country:US
Mailing Address - Phone:404-580-8846
Mailing Address - Fax:
Practice Address - Street 1:1275 SHILOH RD NW
Practice Address - Street 2:SUITE 2770
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7175
Practice Address - Country:US
Practice Address - Phone:404-580-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1536261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)