Provider Demographics
NPI:1013676535
Name:PERSPECTIVES CENTER FOR HOLISTIC THERAPY
Entity type:Organization
Organization Name:PERSPECTIVES CENTER FOR HOLISTIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, APC, MBA
Authorized Official - Phone:404-227-0055
Mailing Address - Street 1:2370 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4456
Mailing Address - Country:US
Mailing Address - Phone:770-634-3285
Mailing Address - Fax:
Practice Address - Street 1:2370 MAIN ST
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4456
Practice Address - Country:US
Practice Address - Phone:770-634-3285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1831247352OtherINDIVIDUAL NPI FOR OWNER LAURIE PATRICE