Provider Demographics
NPI:1821204793
Name:HYPNOSIS CLINIC INC
Entity Type:Organization
Organization Name:HYPNOSIS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-512-0400
Mailing Address - Street 1:4651 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6339
Mailing Address - Country:US
Mailing Address - Phone:770-512-0400
Mailing Address - Fax:
Practice Address - Street 1:4651 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:SUITE D
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6339
Practice Address - Country:US
Practice Address - Phone:770-512-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty