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NPI Code Detail

MEDICARE: TAILORISTE CONSULTANTS, INC.

MEDICARE: TAILORISTE CONSULTANTS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1427911353
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAILORISTE CONSULTANTS, INC.
Provider Business Mailing Address
First Line : 3100 INTERSTATE NORTH CIR SE STE 200
Second Line :
City : ATLANTA
State : GA
Zip : 30339-2384
Country : US
Telephone Number : 770-912-5163
Fax Number :
Provider Business Practice Location Address
First Line : 3100 INTERSTATE NORTH CIR SE STE 200
Second Line :
City : ATLANTA
State : GA
Zip : 30339-2384
Country : US
Telephone Number : 770-912-5163
Fax Number :
Authorized Official
Title or Position : CEO
Name : SHIRLENE MINETA GORDON
Credential : DR., LCSW
Telephone Number : 770-912-5163
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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Directions to “TAILORISTE CONSULTANTS, INC. ” Practice Location

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