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General NPI Number Information
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NPI Number | 1396144317
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Entity Type | Organization
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Legal Business Name | BEGIN WITHIN THERAPY
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 3225 SHALLOWFORD RD SUITE 710
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City | MARIETTA
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State | GA
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Zip | 30062-1266
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Country | US
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Telephone | 678-856-6026
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Fax | 206-338-3936
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Provider Business Mailing Address
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Address Line | 3225 SHALLOWFORD RD SUITE 710
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City | MARIETTA
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State | GA
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Zip | 30062-1266
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Country | US
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Telephone | 678-856-6026
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Fax | 206-338-3936
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Authorized Official
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Title or Position | CLINICAL DIRECTOR & PSYCHOTHERAPIST
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Name | MARY M SMYTH
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Credential | NCC, LPC
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Telephone | 678-856-6026
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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 | LPC008100
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License Number State | GA
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