MANIFESTED DESTINY COUNSELING NPI 1215521687

NPI Information

  • NPI: 1215521687
  • Provider Name: MANIFESTED DESTINY COUNSELING
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 179 HANDLEY RD STE D6
    TYRONE, GA
    ZIP 30290
  • Phone: (404) 819-4295

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NPI Details

MANIFESTED DESTINY COUNSELING is a professional counselor in Tyrone, GA. MANIFESTED DESTINY COUNSELING NPI is 1215521687. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

179 HANDLEY RD STE D6
TYRONE, GA
ZIP 30290-152
Phone: (404) 819-4295

The provider's authorized official is Pamela Elder .
The authorized official title is Owner and has the following contact phone number (678) 682-0415.

The enumeration date for this NPI number is 2/25/2021 and was last updated on 2/25/2021.

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
1101YP2500XCounselorProfessionalYes

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: 11/21/2025

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