FAMILY ART THERAPY CENTER PC NPI 1609916147

NPI Information

NPI: 1609916147
Provider Name: FAMILY ART THERAPY CENTER PC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
109 OLD LIVERY STREET
CLAYTON, GA
ZIP 30525
Phone: (706) 782-0717
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FAMILY ART THERAPY CENTER PC is a professional counselor in Clayton, GA. FAMILY ART THERAPY CENTER PC NPI is 1609916147. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

109 OLD LIVERY STREET
CLAYTON, GA
ZIP 30525
Phone: (706) 782-0717
Fax: (706) 782-5266

The provider's authorized official is Christy Elizabeth Black .
The authorized official title is Ceo and has the following contact phone number (064) 903-5357.

The enumeration date for this NPI number is 2/7/2007 and was last updated on 3/13/2023.

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	LPC 003219	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	10045514	OTHER	GEORGIA	CMO AMERIGROUP
2	743776000	OTHER	GEORGIA	CMO MAGELLAN
3	052483465A	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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