Provider Demographics
NPI:1649051574
Name:COLOR ME THERAPY LLC
Entity type:Organization
Organization Name:COLOR ME THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ LMFT/IMFT
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BESSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-424-8064
Mailing Address - Street 1:8064 S FULTON PKWY APT 2921
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-3083
Mailing Address - Country:US
Mailing Address - Phone:470-424-8064
Mailing Address - Fax:
Practice Address - Street 1:179 HANDLEY RD
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-2154
Practice Address - Country:US
Practice Address - Phone:470-424-8064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty