Provider Demographics
NPI:1932432564
Name:NORTH ATLANTA THERAPY, LLC
Entity Type:Organization
Organization Name:NORTH ATLANTA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROYCE
Authorized Official - Middle Name:CHADWICK
Authorized Official - Last Name:BOATRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-592-8999
Mailing Address - Street 1:99 WEATHERSTONE DR
Mailing Address - Street 2:SUITE 940
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-7005
Mailing Address - Country:US
Mailing Address - Phone:770-592-8999
Mailing Address - Fax:770-926-3728
Practice Address - Street 1:99 WEATHERSTONE DR
Practice Address - Street 2:SUITE 940
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-7005
Practice Address - Country:US
Practice Address - Phone:770-592-8999
Practice Address - Fax:770-926-3728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005684101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty