Organization
BA GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYOTTA HANNAH LPC (CEO)
(404) 599-2615
Entity
Organization
Contact information
Practice address
1514 CLEVELAND AVE, EAST POINT, GA 30344-6965
(477) 329-0110
Mailing address
535 EFFINGHAM HWY, SYLVANIA, GA 30467-7726
(404) 599-2615
(877) 268-1293
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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