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General NPI Number Information
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NPI Number | 1700709250
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Entity Type | Organization
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Legal Business Name | INTENTIONALLY RECONNECTING HEARTS CENTER
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 2900 CHAMBLEE TUCKER RD STE 201
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City | CHAMBLEE
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State | GA
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Zip | 30341-4100
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Country | US
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Telephone | 678-886-3325
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Fax |
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Provider Business Mailing Address
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Address Line | 170 SHOALS CREEK RD
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City | COVINGTON
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State | GA
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Zip | 30016-4198
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Country | US
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Telephone | 678-886-3325
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | DR. SOCROTIFF MICHAEL
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Credential | LPC, LMFT
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Telephone | 678-886-3325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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