Provider Demographics
NPI:1336457530
Name:3D PARTNERS, LLC
Entity Type:Organization
Organization Name:3D PARTNERS, LLC
Other - Org Name:TED LIBERTY, LPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBERTY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-389-8100
Mailing Address - Street 1:2340 PATRICK HENRY PKWY
Mailing Address - Street 2:STE 225
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4325
Mailing Address - Country:US
Mailing Address - Phone:770-389-8100
Mailing Address - Fax:770-389-3030
Practice Address - Street 1:2340 PATRICK HENRY PKWY
Practice Address - Street 2:STE 225
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-4325
Practice Address - Country:US
Practice Address - Phone:770-389-8100
Practice Address - Fax:770-389-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty