Healthcare Provider Details

I. General information

NPI: 1346089091
Provider Name (Legal Business Name): TELOS THERAPEUTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4840 ROSWELL RD STE D300
SANDY SPRINGS GA
30342-2635
US

IV. Provider business mailing address

4840 ROSWELL RD STE D300
SANDY SPRINGS GA
30342-2635
US

V. Phone/Fax

Practice location:
  • Phone: 404-882-9187
  • Fax: 770-995-1959
Mailing address:
  • Phone: 404-882-9187
  • Fax: 770-995-1959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KAREN AKE
Title or Position: OWNER
Credential: LCSW
Phone: 404-882-9187