Provider Demographics
NPI:1457592628
Name:NORTH ATLANTA COUNSELING ASSOCIATES, INC.
Entity Type:Organization
Organization Name:NORTH ATLANTA COUNSELING ASSOCIATES, INC.
Other - Org Name:NORTH ATLANTA CENTER FOR CHRISTIAN COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANKENSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, NCC, CCSAS
Authorized Official - Phone:770-457-3028
Mailing Address - Street 1:2312 PEACHFORD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7143
Mailing Address - Country:US
Mailing Address - Phone:770-457-3028
Mailing Address - Fax:770-457-3046
Practice Address - Street 1:2312 PEACHFORD RD
Practice Address - Street 2:SUITE C
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-7143
Practice Address - Country:US
Practice Address - Phone:770-457-3028
Practice Address - Fax:770-457-3046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH ATLANTA CENTER FOR PROFESSIONAL COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-17
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty