Provider Demographics
NPI:1629374343
Name:GEORGIA THERAPY
Entity Type:Organization
Organization Name:GEORGIA THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:GOLDING
Authorized Official - Last Name:ORANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-849-6586
Mailing Address - Street 1:431 ATLANTA AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-2007
Mailing Address - Country:US
Mailing Address - Phone:404-849-6586
Mailing Address - Fax:
Practice Address - Street 1:675 SEMINOLE AVE NE
Practice Address - Street 2:304
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-3408
Practice Address - Country:US
Practice Address - Phone:404-849-6586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0031051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty