Provider Demographics
NPI:1992321665
Name:DREAM 4 YOU COACHING AND COUNSELING SERVICES
Entity type:Organization
Organization Name:DREAM 4 YOU COACHING AND COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-709-6139
Mailing Address - Street 1:2538 OAK CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6868
Mailing Address - Country:US
Mailing Address - Phone:470-709-6139
Mailing Address - Fax:
Practice Address - Street 1:1540 HIGHWAY 138 SE STE 2K
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1297
Practice Address - Country:US
Practice Address - Phone:470-709-6139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty