Provider Demographics
NPI:1699381475
Name:FAISON, JAMES E
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:FAISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:E
Other - Last Name:FAISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2270 DUNWOODY XING
Mailing Address - Street 2:APT B
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7319
Mailing Address - Country:US
Mailing Address - Phone:407-591-0863
Mailing Address - Fax:
Practice Address - Street 1:2270 DUNWOODY XING
Practice Address - Street 2:APT B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-7319
Practice Address - Country:US
Practice Address - Phone:407-591-0863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst