Provider Demographics
NPI:1477008761
Name:BRIGHT FUTURES CHILD AND FAMILY THERAPY, PC
Entity Type:Organization
Organization Name:BRIGHT FUTURES CHILD AND FAMILY THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRITS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-547-6167
Mailing Address - Street 1:11815 NORTHFALL LN
Mailing Address - Street 2:SUITE #1006
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7973
Mailing Address - Country:US
Mailing Address - Phone:404-547-6167
Mailing Address - Fax:
Practice Address - Street 1:11815 NORTHFALL LN
Practice Address - Street 2:SUITE #1006
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7973
Practice Address - Country:US
Practice Address - Phone:404-547-6167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005830101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty