Provider Demographics
NPI:1962891853
Name:PRACTICAL SOLUTIONS COUNSELING
Entity type:Organization
Organization Name:PRACTICAL SOLUTIONS COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANIE
Authorized Official - Middle Name:WITCRAFT
Authorized Official - Last Name:SHIAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-667-1673
Mailing Address - Street 1:1007 MANSELL RD STE A107
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5019
Mailing Address - Country:US
Mailing Address - Phone:678-667-1673
Mailing Address - Fax:
Practice Address - Street 1:1007 MANSELL RD STE A107
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5019
Practice Address - Country:US
Practice Address - Phone:678-667-1673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
GACSW004647251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003129440EMedicaid