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Organization

PREMIER PSYCHIATRIC & PSYCHOTHERAPY CONSULTING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BETH BOTNICK NP (CFO)
(404) 403-3326
Entity
Organization

Contact information

Practice address
1430 STEPHENS DR NE, ATLANTA, GA 30329-3716
(404) 403-3326
Mailing address
1430 STEPHENS DR NE, ATLANTA, GA 30329-3716
(404) 403-3326

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1134565062
NPI
GA
01
202G702342
MEDICARE ID
GA
Enumeration date
11/08/2013
Last updated
11/08/2013
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