| 3d Psychotherapy, Llc | |
|
1 W Court Sq Suite 750 Decatur GA 30030-2538 | |
| (404) 620-6791 | |
| (404) 494-7701 |
| Full Name | 3d Psychotherapy, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1 W Court Sq, Decatur, Georgia |
| Authorized Official Name and Position | Debra Dantzler (OWNER/THERAPIST) |
| Authorized Official Contact | 4046206791 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 3d Psychotherapy, Llc 1 W Court Sq Suite 750 Decatur GA 30030-2538 Ph: (404) 620-6791 | 3d Psychotherapy, Llc 1 W Court Sq Suite 750 Decatur GA 30030-2538 Ph: (404) 620-6791 |
| NPI Number | 1942743687 |
|---|---|
| Provider Enumeration Date | 11/29/2016 |
| Last Update Date | 11/29/2016 |
| Medicare PECOS PAC ID | 1759728900 |
|---|---|
| Medicare Enrollment ID | O20240322002849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942743687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 005479 (Georgia) | Primary |
| Provider Name | Debra Dantzler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801035670 PECOS PAC ID: 7911344163 Enrollment ID: I20240329002443 |
| Provider Name | Jacinta Wills |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477213817 PECOS PAC ID: 0648619981 Enrollment ID: I20240418003224 |
Joseph T Elder, Psy.d., P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1439 Mclendon Dr Ste D, Decatur, GA 30033 Phone: 404-493-4381 Fax: 770-934-3280 | |
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