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General NPI Number Information
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NPI Number | 1427798891
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Entity Type | Organization
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Legal Business Name | RECOVERY DBT
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 1640 POWERS FERRY ROAD BUILDING 4 SUITE 300
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City | MARIETTA
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State | GA
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Zip | 30067-6404
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Country | US
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Telephone | 678-336-6875
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Fax | 470-275-0630
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Provider Business Mailing Address
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Address Line | 1640 POWERS FERRY RD SE BLDG 4-300
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City | MARIETTA
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State | GA
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Zip | 30067-9409
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Country | US
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Telephone | 678-336-6875
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Fax | 470-275-0630
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MRS. ANN GUZMAN
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Credential | LPC
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Telephone | 678-336-6875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 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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