Provider Demographics
NPI: | 1952185514 |
---|---|
Name: | WOMEN WITH CONFIDENCE THERAPEUTIC SERVICES, LLC |
Entity Type: | Organization |
Organization Name: | WOMEN WITH CONFIDENCE THERAPEUTIC SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MARRIAGE AND FAMILY THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHELSEA |
Authorized Official - Middle Name: | C |
Authorized Official - Last Name: | EDWARDS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMFT |
Authorized Official - Phone: | 404-838-7627 |
Mailing Address - Street 1: | 1495 BRENTWOOD DR |
Mailing Address - Street 2: | |
Mailing Address - City: | MARIETTA |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30062-2044 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3333 PEACHTREE RD NE |
Practice Address - Street 2: | SUITE 150 |
Practice Address - City: | ATLANTA |
Practice Address - State: | GA |
Practice Address - Zip Code: | 30326 |
Practice Address - Country: | US |
Practice Address - Phone: | 404-838-7627 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-08-23 |
Last Update Date: | 2023-08-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |