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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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