| NPI | 1679923122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDRIS TALIB Executive Director 678-794-4846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251S00000X | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |