Provider Demographics
NPI:1750061206
Name:ABBY BEHAVIORAL HEALTH AND PSYCHOTHERAPY INC
Entity type:Organization
Organization Name:ABBY BEHAVIORAL HEALTH AND PSYCHOTHERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLUFUNMILAYO
Authorized Official - Middle Name:TEMITOPE
Authorized Official - Last Name:AJALA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP -BC
Authorized Official - Phone:470-435-5341
Mailing Address - Street 1:2121 FOUNTAIN DR STE D
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2900
Mailing Address - Country:US
Mailing Address - Phone:470-435-5341
Mailing Address - Fax:
Practice Address - Street 1:2121 FOUNTAIN DR STE D
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2900
Practice Address - Country:US
Practice Address - Phone:470-435-5341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health