Organization
CATALYST FOR CHANGE ATLANTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MIKAELA N HEARD LPC (OWNER)
(678) 748-0128
Entity
Organization
Contact information
Practice address
2801 BUFORD HWY NE STE 501, BROOKHAVEN, GA 30329-2137
(678) 748-0128
Mailing address
107 SHADOW LAKE DR, CONYERS, GA 30094-4129
(770) 771-9000
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LPC007304
GA
Other
Enumeration date
09/25/2017
Last updated
10/03/2017
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