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AUTHENTIC LIFE WELLNESS NPI 1972263218


NPI Information

NPI: 1972263218
Provider Name: AUTHENTIC LIFE WELLNESS
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
67 PEACHTREE PARK DR NE STE 102
ATLANTA, GA
ZIP 30309
Phone: (470) 298-6589
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AUTHENTIC LIFE WELLNESS is a counselor in Atlanta, GA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. AUTHENTIC LIFE WELLNESS NPI is 1972263218. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

67 PEACHTREE PARK DR NE STE 102
ATLANTA, GA
ZIP 30309-318
Phone: (470) 298-6589
Fax: (404) 921-9251

The provider's authorized official is Rachelle Kennedy .
The authorized official title is Owner/therapist and has the following contact phone number (678) 296-4133.

The enumeration date for this NPI number is 12/28/2021 and was last updated on 12/28/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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