MARVELOUS LIGHT CONSULTANTS (NPI# 1922145325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922145325 |
| Entity Type | Organization |
| Organization Name | MARVELOUS LIGHT CONSULTANTS |
| Practice Address |
4484 Covington Hwy Suite 100a Decatur GA 30035-1203 |
| Mailing Address |
Po Box 1501 Lithonia GA 30058-1007 |
| Practice Telephone | 4042860054 |
| Practice Fax Number | 4042860064 |
| Mailing Telephone | 4042860054 |
| Mailing Fax Number | 4042860064 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | MRS. DEWANDA B. JACKSON (CEO) |
| Authorized Official Telephone | 4042860054 |
| Authorized Official Credential | MS LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC002390 | GA | Behavioral Health & Social Service Providers |
| Street Address |
4484 COVINGTON HWY SUITE 100A |
| City | DECATUR |
| State | GA |
| Zip Code | 30035-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184761561 | Dewanda B. Jacksoon | Counselor | 4484 Covington Hwy, Suite 100a, Decatur, GA 30035-1203 | 2007-02-01 |
| 1215592431 | Ego Ideal, Inc. | Point of Service | 4484 Covington Hwy, Decatur, GA 30035-1203 | 2019-05-02 |
| 1003392259 | Shanelle Lewis | Spec/Tech, Pathology | 4484 Covington Hwy, Decatur, GA 30035 | 2018-07-11 |
| 1255512521 | Jacquelyn L. Ramsey | Community/Behavioral Health | 4484 Covington Hwy, Suite 100-a, Decatur, GA 30035-1203 | 2007-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972079978 | James L Vinson, Phd | Home Health Aide | 4050 Snapfinger Woods Drive, Suite 201, Decatur, GA 30035 | 2018-10-17 |
| 1417445206 | Kamla Gonzales | Nurse Practitioner | 5146 Miller Woods Trl, Decatur, GA 30035 | 2018-04-26 |
| 1578924924 | Alicia Marie Johnson Bryant | Social Worker | 5878 Covington Hwy, Decater, GA 30035 | 2016-03-14 |
| 1568865756 | Tracy Roberson | Counselor | 4150 Snapfinger Woods Drive, Decatur, GA 30035 | 2014-10-01 |
| 1972927861 | Tyrone D. Lane Enterprises, Incorporated | Psychologist | 5304 Panola Industrial Boulevard, Suite L, Decatur, GA 30035 | 2014-02-12 |
| 1013255355 | Mervin E Williams | Pharmacist | 2075 South Hairston, Decatur, GA 30035 | 2013-01-22 |
| 1205187572 | Mariana Simpson-walker | Speech-Language Pathologist | 4262 Clausell Ct Ste A, Decatur, GA 30035 | 2012-09-27 |
| 1053683854 | Jimiesh G Crane | Dentist | 5243 Snapfinger Woods Dr Ste 105, Decatur, GA 30035 | 2012-02-08 |
| 1568765824 | Salih Robinson | Health Educator | 2511 Lantrac Ct, Decatur, GA 30035 | 2010-12-08 |
| 1831428234 | Thomas Counseling | Counselor | 3781 Presidential Parkway, Suite 111c, Chamblee, GA 30035 | 2009-12-14 |
| Find all providers in zip 30035 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598363392 | Kimberly Swanson | Counselor | 311 West Hill Street, Decatur, GA 30030-4319 | 2020-10-14 |
| 1083228050 | Lasonja D Carter | Counselor | 2920 Frost Dr Sw, Decatur, AL 35603-4531 | 2020-09-07 |
| 1154935468 | Nick Hersey | Counselor | 1924 Clairmont Rd Ste 50, Decatur, GA 30033-3450 | 2020-09-03 |
| 1760095814 | Potters Touch Counseling Inc. | Counselor | 4150 Snapfinger Woods Dr Ste 100, Decatur, GA 30035-3417 | 2020-08-28 |
| 1407464563 | Starre Cannon | Counselor | 3183 Tarian Way, Decatur, GA 30034-5539 | 2020-07-15 |
| 1164040713 | Bethany Cecelia Merrett | Counselor | 223 Kathryn Ave, Decatur, GA 30030-5017 | 2020-07-09 |
| 1053939090 | Virtue Speaks LLC | Counselor | 4150 Snapfinger Woods Dr Ste 104d, Decatur, GA 30035-3417 | 2020-07-07 |
| 1821619842 | Knitikia Gross | Counselor | 436 Eastwyck Cir, Decatur, GA 30032-6694 | 2020-04-30 |
| 1063033074 | Marcy Renee Jefferson-watkins | Counselor | 2126 6th Ave Se Ste 208, Decatur, AL 35601-6547 | 2020-04-30 |
| 1790304004 | Tonia D Morris | Counselor | 3006 Western Sunset Ct, Decatur, GA 30034-1692 | 2020-04-16 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.