Provider Demographics
NPI:1568249845
Name:MY THERAPY DOCTOR LLC
Entity Type:Organization
Organization Name:MY THERAPY DOCTOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOI
Authorized Official - Middle Name:
Authorized Official - Last Name:FARLOUGH BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-840-6596
Mailing Address - Street 1:100 WINDROSE TRCE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8313
Mailing Address - Country:US
Mailing Address - Phone:404-840-6596
Mailing Address - Fax:470-558-2904
Practice Address - Street 1:2009 WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-7931
Practice Address - Country:US
Practice Address - Phone:470-595-1159
Practice Address - Fax:470-558-2904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health