Healthcare Provider Details

I. General information

NPI: 1962358663
Provider Name (Legal Business Name): RESEARCH COMMUNITY CARE OF GEORGIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 POWERS FERRY RD SE STE 200
MARIETTA GA
30067-5491
US

IV. Provider business mailing address

PO BOX 13721
DURHAM NC
27709-3721
US

V. Phone/Fax

Practice location:
  • Phone: 919-706-7160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAKEEMA PRIESTER
Title or Position: ORGANIZING MEMBER
Credential:
Phone: 919-225-9447