Healthcare Provider Details

I. General information

NPI: 1881043420
Provider Name (Legal Business Name): CORE THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2016
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1894 LUDOVIE LN
DECATUR GA
30033-1044
US

IV. Provider business mailing address

1894 LUDOVIE LN
DECATUR GA
30033-1044
US

V. Phone/Fax

Practice location:
  • Phone: 678-626-0557
  • Fax: 678-288-7932
Mailing address:
  • Phone: 678-626-0557
  • Fax: 678-288-7932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-12-10491
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT000418
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KATRINA TODD
Title or Position: EXECUTIVE DIRECTOR
Credential: LMFT, BCBA
Phone: 678-626-0557