Healthcare Provider Details

I. General information

NPI: 1841732633
Provider Name (Legal Business Name): KEEPING IT SPECIALLY SIMPLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 05/02/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 POINTE RIDGE DR
SANDY SPRINGS GA
30328-2755
US

IV. Provider business mailing address

25 POINTE RIDGE DR
SANDY SPRINGS GA
30328-2755
US

V. Phone/Fax

Practice location:
  • Phone: 404-932-4140
  • Fax: 888-838-8656
Mailing address:
  • Phone: 404-932-4140
  • Fax: 865-688-8838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1-16-21587
License Number StateGA

VIII. Authorized Official

Name: BECKY BORAK
Title or Position: CEO
Credential: BCBA
Phone: 404-932-4140