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General NPI Number Information
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NPI Number | 1184564825
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Entity Type | Organization
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Legal Business Name | CONNECTED PATHWAYS OF GEORIGA
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 2180 SHADOWOOD PKWY SE APT 234
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City | ATLANTA
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State | GA
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Zip | 30339-2481
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Country | US
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Telephone | 228-563-3834
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Fax | 228-563-3834
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Provider Business Mailing Address
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Address Line | 2180 SHADOWOOD PKWY SE APT 234
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City | ATLANTA
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State | GA
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Zip | 30339-2481
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Country | US
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Telephone | 228-563-3834
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Fax | 228-563-3834
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JESSICA LEANN BENNETT
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Credential | BENNETT
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Telephone | 228-563-3834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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 | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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