QUINNISE PETTWAY LPC NCC NPI 1144512591

NPI Information

  • NPI: 1144512591
  • Provider Name: QUINNISE PETTWAY, LPC, NCC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 490 SUN VALLEY DR
    SUITE 205
    ROSWELL, GA
    ZIP 30076
  • Phone: (770) 642-4236

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NPI Details

QUINNISE PETTWAY, LPC, NCC is a professional counselor in Roswell, GA. QUINNISE PETTWAY, LPC, NCC NPI is 1144512591. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

490 SUN VALLEY DR
SUITE 205
ROSWELL, GA
ZIP 30076-615
Phone: (770) 642-4236

The provider's authorized official is Quinnise Pettway .
The authorized official title is Owner/president and has the following contact phone number (770) 642-4236.

The enumeration date for this NPI number is 5/4/2011 and was last updated on 5/4/2011.

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
1101YP2500XCounselorProfessionalLPC006121GEORGIAYes

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: 3/30/2025

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