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General NPI Number Information
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NPI Number | 1649647926
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Entity Type | Individual
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Provider Name | ANA EVERETT BS-SOC, MPA, PHD
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Gender | Female
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Dates
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Enumeration Date | 08/21/2015
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Last Update Date | 08/21/2015
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Provider Practice Location Address
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Address Line | 2956 S RAINBOW DR SUITE 103
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City | DECATUR
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State | GA
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Zip | 30034-1629
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Country | US
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Telephone | 888-562-4441
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Fax | 888-562-4441
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Provider Business Mailing Address
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Address Line | 236 AUBURN AVE NE
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City | ATLANTA
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State | GA
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Zip | 30303-2605
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Country | US
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Telephone | 888-562-4441
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Fax | 888-562-4441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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