Provider Demographics
NPI:1447559885
Name:CARE THERAPEUTIC SERVICES, LLC
Entity Type:Organization
Organization Name:CARE THERAPEUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER / THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:404-579-9381
Mailing Address - Street 1:5041 DALLAS HWY
Mailing Address - Street 2:SUITE 402
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6458
Mailing Address - Country:US
Mailing Address - Phone:678-354-5594
Mailing Address - Fax:678-288-7945
Practice Address - Street 1:5041 DALLAS HWY
Practice Address - Street 2:SUITE 402
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-6458
Practice Address - Country:US
Practice Address - Phone:678-354-5594
Practice Address - Fax:678-288-7945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006056101YP2500X
GAMFT001175106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA12214821OtherCAQH