Healthcare Provider Details

I. General information

NPI: 1124504071
Provider Name (Legal Business Name): NEUPATH PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2018
Last Update Date: 02/01/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 SANDY PLAINS RD STE 200
MARIETTA GA
30066-7217
US

IV. Provider business mailing address

2440 SANDY PLAINS RD STE 200
MARIETTA GA
30066-7217
US

V. Phone/Fax

Practice location:
  • Phone: 678-235-5004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CORA CHRISTIE
Title or Position: CEO
Credential:
Phone: 678-235-5004