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General NPI Number Information
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NPI Number | 1578427308
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Entity Type | Organization
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Legal Business Name | ANIALA BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 175 LANGLEY DR STE E3
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-6952
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Country | US
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Telephone | 470-945-1457
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Fax | 404-891-8888
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Provider Business Mailing Address
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Address Line | 175 LANGLEY DR STE E3
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-6952
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Country | US
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Telephone | 470-945-1457
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Fax | 404-891-8888
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | TRACY R GAINER
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Credential | LPC
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Telephone | 678-387-9331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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