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General NPI Number Information
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NPI Number | 1629431390
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Entity Type | Organization
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Legal Business Name | GREATER ATLANTA FAMILY COUNSELING, LLC
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Dates
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Enumeration Date | 03/31/2016
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 165 DEKALB INDUSTRIAL WAY STE G
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City | DECATUR
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State | GA
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Zip | 30030-2230
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Country | US
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Telephone | 770-421-5271
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Fax | 770-995-1959
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Provider Business Mailing Address
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Address Line | 165 DEKALB INDUSTRIAL WAY STE G
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City | DECATUR
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State | GA
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Zip | 30030-2230
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Country | US
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Telephone | 770-421-5271
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Fax | 770-995-1959
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Authorized Official
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Title or Position | LCSW/OWNER
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Name | WILLIAM SMITH
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Credential |
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Telephone | 770-339-7667
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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 | CSW005719
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License Number State | GA
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