Provider Demographics
NPI:1225794969
Name:THE C AGENCY
Entity Type:Organization
Organization Name:THE C AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DELANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STATON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-245-5669
Mailing Address - Street 1:9300 LOTTSFORD RD APT 7408
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4918
Mailing Address - Country:US
Mailing Address - Phone:404-245-5669
Mailing Address - Fax:
Practice Address - Street 1:9300 LOTTSFORD RD APT 7408
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4918
Practice Address - Country:US
Practice Address - Phone:404-245-5669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty