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Organization
THE MARGIE REE HANSFORD THURMOND FAMILY LIFE CENTER
Active
Organization
THE MARGIE REE HANSFORD THURMOND FAMILY LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRNA THURMOND MALONE CPC (CLINICAL DIRECTOR)
(770) 468-7100
Entity
Organization
Contact information
Practice address
710 KING RD, RIVERDALE, GA 30274-2027
(770) 468-7100
Mailing address
9100 AMBERLEIGH LN, RIVERDALE, GA 30274-4682
(770) 468-7100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
NULL
101YP1600X
Pastoral Counselor
Primary
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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