Provider Demographics
NPI:1205394160
Name:NATALIE BRYAN, LCSW L.L.C.
Entity Type:Organization
Organization Name:NATALIE BRYAN, LCSW L.L.C.
Other - Org Name:RESTORING HARMONY COUNSELING & CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-610-8720
Mailing Address - Street 1:2140 RESERVE LN
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-6218
Mailing Address - Country:US
Mailing Address - Phone:516-610-8720
Mailing Address - Fax:
Practice Address - Street 1:104 GREENE ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-1609
Practice Address - Country:US
Practice Address - Phone:762-585-4610
Practice Address - Fax:708-884-1454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty