Organization
CENTER FOR FAMILY PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALIKA S BHARGAVE (OFFICE MANAGER)
(770) 486-1011
Entity
Organization
Contact information
Practice address
120 HANDLEY RD, SUITE 310, TYRONE, GA 30290-2177
(770) 486-1011
(770) 486-1067
Mailing address
120 HANDLEY RD, SUITE 310, TYRONE, GA 30290-2177
(770) 486-1011
(770) 486-1067
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC003177
GA
101YP2500X
Professional Counselor
Primary
LPC003153
GA
103TB0200X
Cognitive & Behavioral Psychologist
PSY002096
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076097468A
—
GA
Enumeration date
11/03/2006
Last updated
03/30/2012
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