Provider Demographics
NPI:1932575438
Name:MARION HARGETT
Entity Type:Organization
Organization Name:MARION HARGETT
Other - Org Name:J&M CONSULTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARION
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:HARGETT
Authorized Official - Suffix:
Authorized Official - Credentials:BEHAVIOR CNAULTANT
Authorized Official - Phone:770-843-3217
Mailing Address - Street 1:3814 BROOKFOREST TRACE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034
Mailing Address - Country:US
Mailing Address - Phone:770-593-3217
Mailing Address - Fax:
Practice Address - Street 1:502 PRYOR ST SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2760
Practice Address - Country:US
Practice Address - Phone:770-843-3217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA305S00000X305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service