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Organization
BEHAVIORAL HEALTH ASSOICATES OF GEORGIA, LLC
Active
Organization
BEHAVIORAL HEALTH ASSOICATES OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELICE MARTIN LPC (CEO)
(770) 376-7635
Entity
Organization
Contact information
Practice address
320 LANIER AVE W, FAYETTEVILLE, GA 30214-1600
(770) 376-7635
(678) 302-0810
Mailing address
320 LANIER AVE W, FAYETTEVILLE, GA 30214-1600
(770) 376-7635
(678) 302-0810
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC009575
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477912111
INDIVIDUAL NPI
—
Enumeration date
01/24/2018
Last updated
01/24/2018
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