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General NPI Number Information
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NPI Number | 1891206413
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Entity Type | Individual
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Provider Name | CYRUS ROUHOLLAH NAHAI M.A., LAPC, CADC II
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Gender | Male
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 23310 PLANTATION DR NE
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City | ATLANTA
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State | GA
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Zip | 30324-2940
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Country | US
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Telephone | 404-992-0344
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Fax |
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Provider Business Mailing Address
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Address Line | 23310 PLANTATION DR NE
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City | ATLANTA
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State | GA
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Zip | 30324-2940
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Country | US
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Telephone | 404-992-0344
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 787
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APC004356
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License Number State | GA
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