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General NPI Number Information
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NPI Number | 1023431210
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Entity Type | Organization
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Legal Business Name | ACCESS MENTAL HEALTH AGENCY
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 215 LAKEWOOD WAY SW 205
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City | ATLANTA
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State | GA
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Zip | 30315-6022
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Country | US
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Telephone | 678-335-9010
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Fax |
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Provider Business Mailing Address
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Address Line | 215 LAKEWOOD WAY SW 205
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City | ATLANTA
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State | GA
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Zip | 30315-6022
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RODERICK BROWN
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Credential |
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Telephone | 678-335-9010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 005397
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 006044
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 006188
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 006400
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 006760
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 006205
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 046882
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 10576464
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 005536
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License Number State | GA
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