Provider Demographics
NPI:1043452980
Name:MCALLISTER, FRANK
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 MEMORIAL DR STE 209C
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-1597
Mailing Address - Country:US
Mailing Address - Phone:404-508-0078
Mailing Address - Fax:404-508-0071
Practice Address - Street 1:4151 MEMORIAL DR STE 209C
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-1597
Practice Address - Country:US
Practice Address - Phone:404-508-0078
Practice Address - Fax:404-508-0071
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001424101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA050029051BMedicaid
GA050029051CMedicaid
GA050029051AMedicaid