Provider Demographics
NPI:1992396840
Name:BRIGHTER DAY BEHAVIORAL HEALTH COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:BRIGHTER DAY BEHAVIORAL HEALTH COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:PELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-621-2422
Mailing Address - Street 1:34 MISTY FOREST DR
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36869-7987
Mailing Address - Country:US
Mailing Address - Phone:580-917-6584
Mailing Address - Fax:
Practice Address - Street 1:233 12TH ST STE 801
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2485
Practice Address - Country:US
Practice Address - Phone:706-619-2869
Practice Address - Fax:706-739-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4506OtherAL LICENSED PROFESSIONAL COUNSELOR
GALPC011981OtherSTATE OF GEORGIA