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General NPI Number Information
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NPI Number | 1922816834
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Entity Type | Organization
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Legal Business Name | DRAGONFLY23CONSULTING
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 1179 TO LANI FARM RD
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-5328
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Country | US
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Telephone | 404-993-1408
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Fax |
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Provider Business Mailing Address
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Address Line | 5600 SPALDING DR UNIT 921004
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City | NORCROSS
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State | GA
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Zip | 30010-4709
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Country | US
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Telephone | 404-993-1408
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | NIN'NUBIYYA ANACIUS-EL
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Credential | LPC
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Telephone | 404-993-1408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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 | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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Taxonomy #5
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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Taxonomy #10
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Taxonomy Code | 333300000X
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Taxonomy Name | Emergency Response System Companies
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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