Provider Demographics
NPI:1619173622
Name:BEHAVIORAL INSTITUTE OF ATLANTA LLC
Entity Type:Organization
Organization Name:BEHAVIORAL INSTITUTE OF ATLANTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:404-256-9325
Mailing Address - Street 1:6000 LAKE FORREST DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:404-256-9325
Mailing Address - Fax:404-256-3662
Practice Address - Street 1:6000 LAKE FORREST DR
Practice Address - Street 2:SUITE 103
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-256-9325
Practice Address - Fax:404-256-3662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty