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ATLANTA PSYCHOTHERAPY NPI 1548228281


NPI Information

NPI: 1548228281
Provider Name: ATLANTA PSYCHOTHERAPY
Classification: Counselor - 101Y00000X
Entity Type: Organization

CLIA Number: 11D1058722

Address:
175 COUNTRY CLUB DR
SUITE 200-E
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 389-1925
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ATLANTA PSYCHOTHERAPY is a counselor in Stockbridge, GA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. ATLANTA PSYCHOTHERAPY NPI is 1548228281. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

175 COUNTRY CLUB DR
SUITE 200-E
STOCKBRIDGE, GA
ZIP 30281-054
Phone: (770) 389-1925
Fax: (770) 389-3077

The provider's authorized official is Dorothy D Watts .
The authorized official title is Owner/therapist and has the following contact phone number (770) 389-1925.

The CLIA number assigned to this NPI record is 11D1058722 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/3/2006 and was last updated on 7/24/2008.


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
1101YA0400XCounselorAddiction (Substance Use Disorder)SAP 10384GEORGIANo
2101Y00000XCounselorCSW 002841GEORGIAYes

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
180BBFNZMEDICARE ID-TYPE UNSPECIFIEDGEORGIA
2P39937MEDICARE UPINGEORGIA
3835815715AMEDICAIDGEORGIA

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

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