Provider Demographics
NPI:1235251869
Name:SAMARITAN COUNSELING CENTER OF ATLANTA INC
Entity Type:Organization
Organization Name:SAMARITAN COUNSELING CENTER OF ATLANTA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:OWENS
Authorized Official - Last Name:KIRWAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-228-7721
Mailing Address - Street 1:1328 PEACHTREE ST NE
Mailing Address - Street 2:SUITE B317
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:404-228-7777
Mailing Address - Fax:404-228-7769
Practice Address - Street 1:1328 PEACHTREE ST NE
Practice Address - Street 2:SUITE B317
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-228-7777
Practice Address - Fax:404-228-7769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty