Provider Demographics
NPI:1194405662
Name:CONNECTED HEARTS COUNSELING LLC
Entity type:Organization
Organization Name:CONNECTED HEARTS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALTRENEASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:679-789-9237
Mailing Address - Street 1:3839 OAKVIEW DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30112
Mailing Address - Country:US
Mailing Address - Phone:678-785-9173
Mailing Address - Fax:
Practice Address - Street 1:3839 OAKVIEW DR
Practice Address - Street 2:SUITE 200
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30112
Practice Address - Country:US
Practice Address - Phone:678-785-9173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty