Provider Demographics
NPI:1235890526
Name:THERAPY CULTURE LLC
Entity Type:Organization
Organization Name:THERAPY CULTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:770-377-1563
Mailing Address - Street 1:5763 VILLAGE LOOP
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4641
Mailing Address - Country:US
Mailing Address - Phone:770-377-1563
Mailing Address - Fax:
Practice Address - Street 1:5763 VILLAGE LOOP
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-4641
Practice Address - Country:US
Practice Address - Phone:770-377-1563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty