Provider Demographics
NPI:1508337924
Name:FAMILY SOLUTIONS OF GEORGIA LLC
Entity Type:Organization
Organization Name:FAMILY SOLUTIONS OF GEORGIA LLC
Other - Org Name:CLARINDA SQUIRES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SQUIRES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-917-9430
Mailing Address - Street 1:6949 MAHONIA PL
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-4588
Mailing Address - Country:US
Mailing Address - Phone:404-917-9430
Mailing Address - Fax:
Practice Address - Street 1:2302 PARKLAKE DR NE STE 533
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2896
Practice Address - Country:US
Practice Address - Phone:678-794-5314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty