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NPI Code Detail

MEDICARE: PREMIER PSYCHIATRIC & PSYCHOTHERAPY CONSULTING

MEDICARE: PREMIER PSYCHIATRIC & PSYCHOTHERAPY CONSULTING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2202G702342OTHERGAMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11134565062OTHERGANPI

General Provider Information

NPI Number : 1790114841
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER PSYCHIATRIC & PSYCHOTHERAPY CONSULTING
Provider Business Mailing Address
First Line : 1430 STEPHENS DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3716
Country : US
Telephone Number : 404-403-3326
Fax Number :
Provider Business Practice Location Address
First Line : 1430 STEPHENS DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3716
Country : US
Telephone Number : 404-403-3326
Fax Number :
Authorized Official
Title or Position : CFO
Name : BETH BOTNICK
Credential : NP
Telephone Number : 404-403-3326
Provider Enumeration Date : 11/08/2013
Last Update Date : 11/08/2013

Similar Medicare Providers

1780676031 — MRS. BETH S BOTNICK NP
Practice Location Address:
1430 STEPHENS DR NE
ATLANTA, GA
30329-3716
Practice Phone: 404-403-3326
Practice Fax:
1982864591 — JOSEPH Y BOTNICK LCSW
Practice Location Address:
1430 STEPHENS DR NE
ATLANTA, GA
30329-3716
Practice Phone: 404-245-6536
Practice Fax:
1417189705 — MS. JENNIFER STOWE LCSW
Practice Location Address:
1430 STEPHENS DR NE
ATLANTA, GA
30329-3716
Practice Phone: 404-245-6536
Practice Fax: 404-320-7211
1285963595 — PREMIER PSYCHIATRIC AND MEDICAL CONSULTANTS
Practice Location Address:
1430 STEPHENS DR NE
ATLANTA, GA
30329-3716
Practice Phone: 404-403-3326
Practice Fax:
1134565062 — PREMIER PSYCHIATRIC AND PSYCHOTHERAPY CONSULTING, LLC
Practice Location Address:
1430 STEPHENS DR NE
ATLANTA, GA
30329-3716
Practice Phone: 404-245-6536
Practice Fax:
1376629717 — DR. RICK A. KUHLMAN D.C.
Practice Location Address:
4205 ROSWELL RD NE
ATLANTA, GA
30342-3716
Practice Phone: 404-250-1414
Practice Fax: 404-250-1415

Directions to “PREMIER PSYCHIATRIC & PSYCHOTHERAPY CONSULTING ” Practice Location

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