Provider Demographics
NPI:1649090846
Name:UPLIFT COUNSELING CENTER
Entity type:Organization
Organization Name:UPLIFT COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, NCC, CACII
Authorized Official - Phone:404-957-8149
Mailing Address - Street 1:4772 ABERDEEN LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-4320
Mailing Address - Country:US
Mailing Address - Phone:404-957-8149
Mailing Address - Fax:
Practice Address - Street 1:4772 ABERDEEN LN
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-4320
Practice Address - Country:US
Practice Address - Phone:404-957-8149
Practice Address - Fax:404-393-6187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-12
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty