Provider Demographics
NPI:1629431390
Name:GREATER ATLANTA FAMILY COUNSELING, LLC
Entity Type:Organization
Organization Name:GREATER ATLANTA FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-339-7667
Mailing Address - Street 1:165 DEKALB INDUSTRIAL WAY
Mailing Address - Street 2:STE G
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2230
Mailing Address - Country:US
Mailing Address - Phone:770-421-5271
Mailing Address - Fax:770-995-1959
Practice Address - Street 1:165 DEKALB INDUSTRIAL WAY
Practice Address - Street 2:STE G
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2230
Practice Address - Country:US
Practice Address - Phone:770-421-5271
Practice Address - Fax:770-995-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0057191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty