Provider Demographics
NPI:1568767101
Name:HANDY, BENJAMIN MORRIS
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MORRIS
Last Name:HANDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MORRIS
Other - Middle Name:
Other - Last Name:HANDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:300 VILLAGE GREEN CIR SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-3476
Mailing Address - Country:US
Mailing Address - Phone:404-661-4954
Mailing Address - Fax:
Practice Address - Street 1:300 VILLAGE GREEN CIR SE
Practice Address - Street 2:SUITE 201
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-3476
Practice Address - Country:US
Practice Address - Phone:404-661-4954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001640101Y00000X
IN07130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)