Provider Demographics
NPI:1528406634
Name:INTOWN COUNSELING & WELLNESS
Entity Type:Organization
Organization Name:INTOWN COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-478-9890
Mailing Address - Street 1:27 ROCKLAND PL
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1075 ZONOLITE RD NE
Practice Address - Street 2:STE 1A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-2013
Practice Address - Country:US
Practice Address - Phone:404-478-9890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty