Provider Demographics
NPI:1821697475
Name:MOSHE MANHEIM, LCSW
Entity Type:Organization
Organization Name:MOSHE MANHEIM, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-469-3631
Mailing Address - Street 1:6740 JAMESTOWN DR.
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005
Mailing Address - Country:US
Mailing Address - Phone:678-469-3631
Mailing Address - Fax:678-339-1221
Practice Address - Street 1:6740 JAMESTOWN DR.
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005
Practice Address - Country:US
Practice Address - Phone:678-469-3631
Practice Address - Fax:678-339-1221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty