Provider Demographics
NPI:1124592332
Name:CENTER FOR STRESS MANAGEMENT & PSYCHOLOGICAL SERVICES (THE CENTER)
Entity Type:Organization
Organization Name:CENTER FOR STRESS MANAGEMENT & PSYCHOLOGICAL SERVICES (THE CENTER)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DAMAFING
Authorized Official - Middle Name:KEITA
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-977-1532
Mailing Address - Street 1:1787 DEER CROSSING WAY
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-5199
Mailing Address - Country:US
Mailing Address - Phone:678-977-1532
Mailing Address - Fax:
Practice Address - Street 1:3825 JODECO RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-5423
Practice Address - Country:US
Practice Address - Phone:678-961-3871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty