Provider Demographics
NPI:1295013829
Name:THERAPY GIRL LLC
Entity Type:Organization
Organization Name:THERAPY GIRL LLC
Other - Org Name:THERAPY GIRL COUNSELING & CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLARTY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-864-5445
Mailing Address - Street 1:1825 MORNING STAR LN
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-7150
Mailing Address - Country:US
Mailing Address - Phone:770-864-5445
Mailing Address - Fax:404-592-6425
Practice Address - Street 1:3996 CLAIRMONT RD
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-4938
Practice Address - Country:US
Practice Address - Phone:770-864-5445
Practice Address - Fax:404-592-6425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty