Provider Demographics
NPI:1386467348
Name:METAMORPHOSIS COUNSELING & CONSULTING, LLC
Entity type:Organization
Organization Name:METAMORPHOSIS COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:478-233-6241
Mailing Address - Street 1:113 ASBELL ST # 625
Mailing Address - Street 2:
Mailing Address - City:IRWINTON
Mailing Address - State:GA
Mailing Address - Zip Code:31042-2556
Mailing Address - Country:US
Mailing Address - Phone:478-233-6241
Mailing Address - Fax:478-233-6241
Practice Address - Street 1:113 ASBELL ST # 625
Practice Address - Street 2:
Practice Address - City:IRWINTON
Practice Address - State:GA
Practice Address - Zip Code:31042-2556
Practice Address - Country:US
Practice Address - Phone:478-233-6241
Practice Address - Fax:478-233-6241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty