Provider Demographics
NPI:1609279538
Name:MUSLIMAH CONSULTATION GROUP, INC.
Entity Type:Organization
Organization Name:MUSLIMAH CONSULTATION GROUP, INC.
Other - Org Name:MCG, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TARYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIDDIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CWSMT,CMHFAT,
Authorized Official - Phone:404-663-1135
Mailing Address - Street 1:1785 E PARK PLACE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3458
Mailing Address - Country:US
Mailing Address - Phone:404-663-1135
Mailing Address - Fax:888-678-1435
Practice Address - Street 1:3300 MEMORIAL DR STE D1
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-2700
Practice Address - Country:US
Practice Address - Phone:404-663-1135
Practice Address - Fax:888-678-1435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty