Provider Demographics
NPI:1275795155
Name:WE LISTEN, LLC
Entity Type:Organization
Organization Name:WE LISTEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:BRONFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-417-2721
Mailing Address - Street 1:4530 S BERKELEY LAKE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-1660
Mailing Address - Country:US
Mailing Address - Phone:770-446-5642
Mailing Address - Fax:770-446-5643
Practice Address - Street 1:4530 S BERKELEY LAKE RD
Practice Address - Street 2:SUITE B
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1660
Practice Address - Country:US
Practice Address - Phone:770-446-5642
Practice Address - Fax:770-446-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW003592251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA153347849BMedicaid
GA153347849BMedicaid