| Mtj Psychiatric Services Inc | |
|
1291 Stanley Rd Kennesaw GA 30152 | |
| (770) 427-0147 | |
| (770) 427-4699 |
| Full Name | Mtj Psychiatric Services Inc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 1291 Stanley Rd, Kennesaw, Georgia |
| Authorized Official Name and Position | Martin Thomas Johnson (CEO) |
| Authorized Official Contact | 6789847557 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mtj Psychiatric Services Inc 5907 Buckner Creek Dr Mableton GA 30126 Ph: () - | Mtj Psychiatric Services Inc 1291 Stanley Rd Kennesaw GA 30152 Ph: (770) 427-0147 |
| NPI Number | 1487617197 |
|---|---|
| Provider Enumeration Date | 04/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487617197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 049301 (Georgia) | Primary |
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