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General NPI Number Information
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NPI Number | 1295044204
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Entity Type | Organization
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Legal Business Name | PERIMETER THERAPY ASSOCIATES LLC
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Dates
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Enumeration Date | 09/26/2010
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1455 LINCOLN PKWY E STE 300
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City | ATLANTA
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State | GA
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Zip | 30346-2209
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Country | US
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Telephone | 678-666-4717
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Fax |
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Provider Business Mailing Address
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Address Line | 1232 MINHINETTE DR
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City | ROSWELL
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State | GA
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Zip | 30075-3623
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Country | US
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Telephone | 678-777-8744
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Fax | 404-201-2912
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Authorized Official
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Title or Position | DIRECTOR
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Name | HEATHER V YOUNGBLOOD
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Credential | LCSW
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Telephone | 678-777-8744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2730
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License Number State | GA
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