Provider Demographics
NPI:1285997551
Name:MASTER PLAN CHRISTIAN COUNSELING
Entity type:Organization
Organization Name:MASTER PLAN CHRISTIAN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PASTORAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:IVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-241-4861
Mailing Address - Street 1:3632 RIVER HEIGHTS XING SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4870
Mailing Address - Country:US
Mailing Address - Phone:773-241-4861
Mailing Address - Fax:678-504-5590
Practice Address - Street 1:133 JOHNSON FERRY RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4923
Practice Address - Country:US
Practice Address - Phone:773-241-4861
Practice Address - Fax:678-504-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA02127178251S00000X
GA02125023251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health