| Ohm Psycotherapy Inc | |
|
3594 Old Chamblee Tucker Rd Atlanta GA 30341 | |
| (770) 375-0479 | |
| (678) 985-4228 |
| Full Name | Ohm Psycotherapy Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3594 Old Chamblee Tucker Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Opal H Minott (LIC CLINICAL SOCIAL WRKR THERAPIST) |
| Authorized Official Contact | 7703750479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohm Psycotherapy Inc 1083 Simonton Hill Ct Lawrenceville GA 30045 Ph: (770) 375-0479 | Ohm Psycotherapy Inc 3594 Old Chamblee Tucker Rd Atlanta GA 30341 Ph: (770) 375-0479 |
| NPI Number | 1912181082 |
|---|---|
| Provider Enumeration Date | 12/24/2007 |
| Last Update Date | 12/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912181082 | NPI | - | NPPES |
| 286447905A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW003893 (Georgia) | Primary |
| 1041C0700X | Social Worker - Clinical | R0441101 (New York) | Secondary |
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