Provider Demographics
NPI:1326256421
Name:EMMANUEL CENTER FOR PASTORAL COUNSELING OF ST. BARTHOLOMEW'S EPISCOPAL
Entity Type:Organization
Organization Name:EMMANUEL CENTER FOR PASTORAL COUNSELING OF ST. BARTHOLOMEW'S EPISCOPAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BONDI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-634-3336
Mailing Address - Street 1:1790 LAVISTA RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3604
Mailing Address - Country:US
Mailing Address - Phone:404-634-3336
Mailing Address - Fax:404-634-0505
Practice Address - Street 1:1790 LAVISTA RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3604
Practice Address - Country:US
Practice Address - Phone:404-634-3336
Practice Address - Fax:404-634-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty