Healthcare Provider Details

I. General information

NPI: 1053636316
Provider Name (Legal Business Name): RASHIDA BYAMS OTR/L, CRC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 PHARR COURT NORTH NW SUITE 31
ATLANTA GA
30305-2052
US

IV. Provider business mailing address

PO BOX 462
DECATUR GA
30031-0462
US

V. Phone/Fax

Practice location:
  • Phone: 404-362-7005
  • Fax: 866-242-6336
Mailing address:
  • Phone: 404-362-7005
  • Fax: 866-242-6336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number001883
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001883
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number001883
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number003835
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number003835
License Number StateGA
# 6
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number003835
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number003835
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: