1457871089 NPI number — QUALITY CONNECTIONS COUNSELING AND CONSULTING

Table of content: (NPI 1457871089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457871089 NPI number — QUALITY CONNECTIONS COUNSELING AND CONSULTING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY CONNECTIONS COUNSELING AND CONSULTING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457871089
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2467 PEACH SHOALS CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DACULA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30019-2173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-628-8326
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 CHAMBLEE TUCKER RD BLDG 16
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30341-4148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-692-2157
Provider Business Practice Location Address Fax Number:
770-538-1992
Provider Enumeration Date:
06/25/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARRIS-JAMES
Authorized Official First Name:
TAMEKA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
347-628-8326

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)