Provider Demographics
NPI:1437778354
Name:THERAPEUTIC ALLIANCE LLC
Entity type:Organization
Organization Name:THERAPEUTIC ALLIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BUDDLE-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-699-6208
Mailing Address - Street 1:2300 LAKEVIEW PARKWAY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009
Mailing Address - Country:US
Mailing Address - Phone:678-699-6208
Mailing Address - Fax:678-916-3810
Practice Address - Street 1:2300 LAKEVIEW PARKWAY
Practice Address - Street 2:SUITE 700
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009
Practice Address - Country:US
Practice Address - Phone:678-699-6208
Practice Address - Fax:678-916-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty