=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003767401
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EXCEL DNA TESTING & DRUG TESTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2026
-----------------------------------------------------
Last Update Date | 02/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2310 PARKLAKE DR NE STE 470
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30345-3067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-852-0132
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5722 GREENRIDGE CT
-----------------------------------------------------
City | LITHONIA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30058-2202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-597-2390
-----------------------------------------------------
Fax | 404-597-2390
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | GWENDOLYN R SHUMATE-WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 404-597-2390
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------