Healthcare Provider Details

I. General information

NPI: 1528444072
Provider Name (Legal Business Name): THERAPEUTIC THINKING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2015
Last Update Date: 08/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1287 MARKS CHURCH RD STE 1
AUGUSTA GA
30909
US

IV. Provider business mailing address

1287 MARKS CHURCH RD STE 1
AUGUSTA GA
30909-6330
US

V. Phone/Fax

Practice location:
  • Phone: 706-373-0579
  • Fax: 844-385-8096
Mailing address:
  • Phone: 706-373-0579
  • Fax: 844-385-8096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHONTINA JOHNSON FLOYD
Title or Position: OWNER
Credential:
Phone: 706-373-0579