ATLANTA COUNSELING & DIAGNOTICS CENTER LLC NPI 1265825566

NPI Information

NPI: 1265825566
Provider Name: ATLANTA COUNSELING & DIAGNOTICS CENTER LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
2090 SUGARLOAF PKWY STE 115
LAWRENCEVILLE, GA
ZIP 30045
Phone: (770) 658-4833
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ATLANTA COUNSELING & DIAGNOTICS CENTER LLC is a professional counselor in Lawrenceville, GA. ATLANTA COUNSELING & DIAGNOTICS CENTER LLC NPI is 1265825566. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2090 SUGARLOAF PKWY STE 115
LAWRENCEVILLE, GA
ZIP 30045-402
Phone: (770) 658-4833

The provider's authorized official is Jerrell Walker .
The authorized official title is Owner/operater and has the following contact phone number (770) 676-0589.

The enumeration date for this NPI number is 3/10/2015 and was last updated on 12/23/2022.

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
1	101YP2500X	Counselor	Professional			No
2	101YP2500X	Counselor	Professional	007754	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003230686A	MEDICAID	GEORGIA
2	003153183B	MEDICAID	GEORGIA

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: 5/5/2024

NPI Synchronization or Removal

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