Provider Demographics
NPI:1366055725
Name:REJUVENATION COUNSELING COACHING & CONSULTING LLC
Entity type:Organization
Organization Name:REJUVENATION COUNSELING COACHING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHRISTIAN PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICCKAY
Authorized Official - Middle Name:
Authorized Official - Last Name:NATSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:912-660-9760
Mailing Address - Street 1:1029 N PEACHTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4210
Mailing Address - Country:US
Mailing Address - Phone:404-999-3618
Mailing Address - Fax:
Practice Address - Street 1:1029 N PEACHTREE PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:404-999-3618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty