Life Source Counseling & Consulting, LLC

NPI #1972123362 in Jonesboro, Georgia

Provider Information

NPI Number: 1972123362
Entity Type: Organization
Organization Name: Life Source Counseling & Consulting, LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Apr 25, 2020
Last Updated: Apr 25, 2020

Practice Location

Address: 118 NORTH AVENUE, SUITE A
City: Jonesboro
State: Georgia
ZIP Code: 30236
Phone: (404) 372-8941

Authorized Official

Name: DR. STEPHANE EVETTE WILLIAMS, LPC
Title: LICENSED PROFESSIONAL COUNSELOR
Phone: (404) 372-8941

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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