Provider Demographics
NPI:1710660899
Name:GEORGIA FAMILY THERAPY
Entity Type:Organization
Organization Name:GEORGIA FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AURELIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:678-379-7825
Mailing Address - Street 1:6190 POWERS FERRY RD STE 520
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4450
Mailing Address - Country:US
Mailing Address - Phone:678-379-7825
Mailing Address - Fax:
Practice Address - Street 1:6190 POWERS FERRY RD STE 520
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4450
Practice Address - Country:US
Practice Address - Phone:678-379-7825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center