Provider Demographics
NPI:1396320180
Name:FLOURISH COUNSELING AND WELLNESS
Entity type:Organization
Organization Name:FLOURISH COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LPC
Authorized Official - Phone:404-694-5626
Mailing Address - Street 1:2483 HERITAGE VLG STE 16-139
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6140
Mailing Address - Country:US
Mailing Address - Phone:470-709-2792
Mailing Address - Fax:
Practice Address - Street 1:2483 HERITAGE VLG STE 16-139
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6140
Practice Address - Country:US
Practice Address - Phone:470-709-2792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty