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General NPI Number Information
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NPI Number | 1780088195
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Entity Type | Organization
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Legal Business Name | GLOBECORE, INC.
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 3355 LENOX RD NE STE 1000
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City | ATLANTA
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State | GA
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Zip | 30326
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Country | US
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Telephone | 770-284-1044
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Fax | 404-228-3860
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Provider Business Mailing Address
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Address Line | 2031 PINNACLE POINTE DR
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City | NORCROSS
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State | GA
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Zip | 30071-4917
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Country | US
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Telephone | 404-641-7705
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Fax | 770-559-9015
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Authorized Official
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Title or Position | PRESIDENT/LICENSED PSYCHOLOGIST
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Name | DR. KELLY MICHELLE LEWIS
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Credential | PH.D.
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Telephone | 404-641-7705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY003785
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License Number State | GA
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