Provider Demographics
NPI:1093243214
Name:GEORGIA BEHAVIOR SPECIALISTS, INC.
Entity Type:Organization
Organization Name:GEORGIA BEHAVIOR SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:GREENE
Authorized Official - Last Name:SCHUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:BACB
Authorized Official - Phone:770-630-0964
Mailing Address - Street 1:298 SEAVY ST
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276-1806
Mailing Address - Country:US
Mailing Address - Phone:770-630-0964
Mailing Address - Fax:
Practice Address - Street 1:298 SEAVY ST
Practice Address - Street 2:
Practice Address - City:SENOIA
Practice Address - State:GA
Practice Address - Zip Code:30276-1806
Practice Address - Country:US
Practice Address - Phone:770-630-0964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-17-25626103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty