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Organization

HOLISTIC ATLANTA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VAUGHN GAY DSW, LPC (EXECUTIVE DIRECTOR)
(404) 808-0870
Entity
Organization

Contact information

Practice address
6886 MAIN ST, STONECREST, GA 30058-4508
(404) 808-0870
(470) 201-1205
Mailing address
3247 ROCKVIEW DR STE A, STONECREST, GA 30038-3032
(404) 808-0870

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
163WP0808X
Psychiatric/Mental Health Registered Nurse
208000000X
Pediatrics Physician
2084P0800X
Psychiatry Physician
251E00000X
Home Health Agency
251K00000X
Public Health or Welfare Agency

Other

Enumeration date
12/29/2020
Last updated
12/29/2020
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