Healthcare Provider Details

I. General information

NPI: 1043010424
Provider Name (Legal Business Name): HCF PREVENTATIVE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2025
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

957 MAIN ST
STONE MOUNTAIN GA
30083-3060
US

IV. Provider business mailing address

957 MAIN ST STE A-108
STONE MOUNTAIN GA
30083-3060
US

V. Phone/Fax

Practice location:
  • Phone: 470-336-2149
  • Fax:
Mailing address:
  • Phone: 470-336-2149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: HONIDU MARICO
Title or Position: COGNITIVE BEHAVIORAL COACH
Credential: CHW
Phone: 470-336-2149