Healthcare Provider Details

I. General information

NPI: 1326854191
Provider Name (Legal Business Name): T2S C.A.R.E.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MARTIN LUTHER KING JR DR SW STE 530
ATLANTA GA
30310-5807
US

IV. Provider business mailing address

PO BOX 43971
ATLANTA GA
30336-0971
US

V. Phone/Fax

Practice location:
  • Phone: 585-438-3791
  • Fax: 770-341-4827
Mailing address:
  • Phone: 585-438-3791
  • Fax: 770-341-4827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH CLANTON
Title or Position: BOARD MEMBER
Credential:
Phone: 404-914-4782