Healthcare Provider Details

I. General information

NPI: 1467394817
Provider Name (Legal Business Name): INTERLINKED COMMUNITY BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 COMMERCIAL DR SW STE B
CONYERS GA
30094-5991
US

IV. Provider business mailing address

1257 COMMERCIAL DR SW STE B
CONYERS GA
30094-5991
US

V. Phone/Fax

Practice location:
  • Phone: 770-285-6049
  • Fax:
Mailing address:
  • Phone: 770-285-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. D'ANTHONY T HARRIS
Title or Position: CEO
Credential: LPC
Phone: 770-285-6049