Healthcare Provider Details

I. General information

NPI: 1346921012
Provider Name (Legal Business Name): THE PSYCH CONSULTANT COMPREHENSIVE MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 PEACHTREE RD NE STE D635
ATLANTA GA
30309-1148
US

IV. Provider business mailing address

2221 PEACHTREE RD NE STE D635
ATLANTA GA
30309-1148
US

V. Phone/Fax

Practice location:
  • Phone: 678-800-4992
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIERRIA OGIAMIEN
Title or Position: OWNER
Credential:
Phone: 601-917-1534