Provider Demographics
NPI:1245865633
Name:TRADEMARK CHILD AND FAMILY SERVICES INC
Entity type:Organization
Organization Name:TRADEMARK CHILD AND FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYCHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:270-312-5386
Mailing Address - Street 1:441 WALNUT CREEK DR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5878
Mailing Address - Country:US
Mailing Address - Phone:470-775-3195
Mailing Address - Fax:
Practice Address - Street 1:2001 MLK DR SW STE 402
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-5802
Practice Address - Country:US
Practice Address - Phone:470-775-3195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-06
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty