Organization
SOUTHEASTERN BEHAVIORAL HEALTH AND CONSULTING
Active
Organization
SOUTHEASTERN BEHAVIORAL HEALTH AND CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MITCHELL (CHIEF MANAGING OFFICER)
(404) 516-1996
Entity
Organization
Contact information
Practice address
53 POPLAR ST, NEWNAN, GA 30263-1039
(404) 516-1996
Mailing address
2997 COBB PKWY SE UNIT 725575, ATLANTA, GA 31139-2703
(404) 516-1996
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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