Individual
TYRONE MAURICE CAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 GEORGIA AVE SE STE 206, ATLANTA, GA 30312-3000
(757) 692-0366
Mailing address
325 FAULKNER ST, STOCKBRIDGE, GA 30281-2819
(757) 692-0366
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103146
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2095
GA
132700000X
Dietary Manager
1230989815
GA
171M00000X
Case Manager/Care Coordinator
315103
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0710103146
CERTIFIED SUBSTANCE ABUSE COUNSELOR
VA
01
—
1230989815
CERTIFIED NUTRITION COACH
GA
01
—
2095
CERTIFIED SUBSTANCE ABUSE COUNSELOR
GA
01
—
2095
CERTIFIED ADVANCE ALCOHOL AND DRUG COUNSELOR
VA
Enumeration date
03/23/2021
Last updated
08/16/2023
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