Provider Demographics
NPI:1760055461
Name:THE ANXIETY COUNSELING CENTER
Entity Type:Organization
Organization Name:THE ANXIETY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:COTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-218-9265
Mailing Address - Street 1:1084 CLUB TRCE NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-2659
Mailing Address - Country:US
Mailing Address - Phone:404-402-2176
Mailing Address - Fax:
Practice Address - Street 1:2801 BUFORD HWY NE STE 501
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-2137
Practice Address - Country:US
Practice Address - Phone:404-402-2176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health