ROAD TO SUCCESS NPI 1205283520

NPI Information

NPI: 1205283520
Provider Name: ROAD TO SUCCESS
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
305 W SPRING ST
MOUNT VERNON, GA
ZIP 30445
Phone: (912) 423-0498
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ROAD TO SUCCESS is a professional counselor in Mount Vernon, GA. ROAD TO SUCCESS NPI is 1205283520. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

305 W SPRING ST
MOUNT VERNON, GA
ZIP 30445-837
Phone: (912) 423-0498
Fax: (912) 583-0115

The provider's authorized official is Paulett Chavers .
The authorized official title is Vp and has the following contact phone number (912) 423-0498.

The enumeration date for this NPI number is 5/17/2016 and was last updated on 5/17/2016.

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
1	101Y00000X	Counselor		LPC007564	GEORGIA	No
2	251S00000X	Community/Behavioral Health		LPC007564	GEORGIA	No
3	101YP2500X	Counselor	Professional	LPC007564	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003155049B	MEDICAID	GEORGIA

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

NPI Synchronization or Removal

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