Provider Demographics
NPI:1699171900
Name:REVEALING MOMENTS COUNSELING & CONSULTANTS, LLC
Entity type:Organization
Organization Name:REVEALING MOMENTS COUNSELING & CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOTHERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:G
Authorized Official - Last Name:OGLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CAMS
Authorized Official - Phone:770-309-2766
Mailing Address - Street 1:1109 W PEACHTREE ST NW
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3608
Mailing Address - Country:US
Mailing Address - Phone:770-309-2766
Mailing Address - Fax:404-393-0163
Practice Address - Street 1:1109 W PEACHTREE ST NW
Practice Address - Street 2:SUITE 700
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3608
Practice Address - Country:US
Practice Address - Phone:770-309-2766
Practice Address - Fax:404-393-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004928101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC004928OtherLICENSED PROFESSIONAL COUNSELOR