My Epiphany Counseling and Consultation Services, Llc.

NPI #1366730079 in Tyrone, Georgia

Provider Information

NPI Number: 1366730079
Entity Type: Organization
Organization Name: My Epiphany Counseling and Consultation Services, Llc.
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Jul 14, 2011
Last Updated: Nov 10, 2023

Practice Location

Address: 120 MILLBROOK VILLAGE DR
City: Tyrone
State: Georgia
ZIP Code: 30290-3605
Phone: (678) 263-8830

Authorized Official

Name: MS. JEMEKA LASHAY STALLWORTH, LPC
Title: CLINICAL DIRECTOR/CO-OWNER
Phone: (205) 919-6327

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Counselor - Professional — Professional	101YP2500X
Case Management	251B00000X
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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