Provider Demographics
NPI:1720604804
Name:ANGELA CULBRETH LLC
Entity Type:Organization
Organization Name:ANGELA CULBRETH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:GURR
Authorized Official - Last Name:CULBRETH
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:678-521-4292
Mailing Address - Street 1:567 GREENWOOD AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1839
Mailing Address - Country:US
Mailing Address - Phone:678-521-4292
Mailing Address - Fax:
Practice Address - Street 1:1151 SHERIDAN RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3714
Practice Address - Country:US
Practice Address - Phone:404-828-0852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty