Organization
CORE THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA TODD LAMFT, BCBA, MT-BC (EXECUTIVE DIRECTOR)
(678) 626-0557
Entity
Organization
Contact information
Practice address
3760 LAVISTA RD STE 102, TUCKER, GA 30084-5622
(678) 626-0557
(678) 288-7932
Mailing address
PO BOX 170062, ATLANTA, GA 30317-0062
(678) 626-0557
(678) 288-7932
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-10491
GA
103K00000X
Behavior Analyst
1-15-19619
GA
106H00000X
Marriage & Family Therapist
AMFT000418
GA
174400000X
Specialist
MUT000049
GA
246Z00000X
Other Specialist/Technologist
RBT-16-19812
GA
Other
Enumeration date
06/05/2016
Last updated
02/10/2021
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