Healthcare Provider Details

I. General information

NPI: 1114722006
Provider Name (Legal Business Name): CONNECTING AUTISM SERVICES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 WALL ST SE STE 290
CONYERS GA
30013-6703
US

IV. Provider business mailing address

2395 WALL ST SE STE 290
CONYERS GA
30013-6703
US

V. Phone/Fax

Practice location:
  • Phone: 404-844-9710
  • Fax: 470-200-2171
Mailing address:
  • Phone: 404-844-9710
  • Fax: 470-200-2171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHERRI TEIXEIRA
Title or Position: OWNER
Credential: BS
Phone: 404-844-9710