Provider Demographics
NPI:1013223577
Name:HARDEN BEHAVIORAL SOLUTIONS, INC
Entity Type:Organization
Organization Name:HARDEN BEHAVIORAL SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENITA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-417-2779
Mailing Address - Street 1:PO BOX 33023
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-0023
Mailing Address - Country:US
Mailing Address - Phone:770-417-2779
Mailing Address - Fax:435-417-2775
Practice Address - Street 1:2 RAVINIA DR
Practice Address - Street 2:SUITE 500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2104
Practice Address - Country:US
Practice Address - Phone:770-417-2779
Practice Address - Fax:435-417-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002966101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA244385645BMedicaid