Provider Demographics
NPI:1013305523
Name:CONCENTRIC BEHAVIORAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:CONCENTRIC BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANDERSON
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-491-0299
Mailing Address - Street 1:222 COLONIAL HOMES DR NW UNIT 2209
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1624
Mailing Address - Country:US
Mailing Address - Phone:678-799-9900
Mailing Address - Fax:404-369-1838
Practice Address - Street 1:1246 CONCORD RD SE STE 203
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4394
Practice Address - Country:US
Practice Address - Phone:404-491-0299
Practice Address - Fax:404-369-1838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW-0048171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty