Provider Demographics
NPI:1912398868
Name:THE NORTHROP CONNECTION, LLC
Entity Type:Organization
Organization Name:THE NORTHROP CONNECTION, LLC
Other - Org Name:NORTHROP COUNSELING, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:NORTHROP
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-332-7955
Mailing Address - Street 1:702 W MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-4122
Mailing Address - Country:US
Mailing Address - Phone:678-332-7955
Mailing Address - Fax:
Practice Address - Street 1:702 W MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-4122
Practice Address - Country:US
Practice Address - Phone:678-332-7955
Practice Address - Fax:678-719-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0048651041C0700X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5150Medicare UPIN