| Charnat Llc | |
|
3911 Mary Eliza Trce Nw Ste 200 Marietta GA 30064-1088 | |
| (678) 631-9907 | |
| Not Available |
| Full Name | Charnat Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3911 Mary Eliza Trce Nw Ste 200, Marietta, Georgia |
| Authorized Official Name and Position | Charlett Harris (OWNER) |
| Authorized Official Contact | 6786319907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charnat Llc 3911 Mary Eliza Trce Nw Ste 200 Marietta GA 30064-1088 Ph: (678) 631-9907 | Charnat Llc 3911 Mary Eliza Trce Nw Ste 200 Marietta GA 30064-1088 Ph: (678) 631-9907 |
| NPI Number | 1154995629 |
|---|---|
| Provider Enumeration Date | 05/18/2021 |
| Last Update Date | 05/18/2021 |
| Certification Date | 05/18/2021 |
| Medicare PECOS PAC ID | 1153774799 |
|---|---|
| Medicare Enrollment ID | O20240130002514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154995629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Charlett Theresa Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720660855 PECOS PAC ID: 5193119576 Enrollment ID: I20240130002734 |
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