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General NPI Number Information
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NPI Number | 1154597847
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Entity Type | Organization
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Legal Business Name | CVC ASSOCIATES, INC.
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 4617 WATERFORD CT
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City | ATLANTA
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State | GA
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Zip | 30338-3137
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Country | US
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Telephone | 678-579-0637
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Fax |
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Provider Business Mailing Address
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Address Line | 4617 WATERFORD CT
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City | ATLANTA
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State | GA
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Zip | 30338-3137
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Country | US
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Telephone | 678-579-0637
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATHLEEN A. CONNORS
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Credential | PHD
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Telephone | 678-579-0637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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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 | 003067
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License Number State | GA
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