| Perimeter Therapy Associates S-corp | |
|
1455 Lincoln Parkway Suite 240 Atlanta GA 30346-1308 | |
| (678) 666-4717 | |
| Not Available |
| Full Name | Perimeter Therapy Associates S-corp |
|---|---|
| Speciality | Social Worker |
| Location | 1455 Lincoln Parkway, Atlanta, Georgia |
| Authorized Official Name and Position | Heather V Youngblood (DIRECTOR) |
| Authorized Official Contact | 6787778744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perimeter Therapy Associates S-corp 424 Highlands Loop Woodstock GA 30188 Ph: (678) 777-8744 | Perimeter Therapy Associates S-corp 1455 Lincoln Parkway Suite 240 Atlanta GA 30346-1308 Ph: (678) 666-4717 |
| NPI Number | 1295044204 |
|---|---|
| Provider Enumeration Date | 09/26/2010 |
| Last Update Date | 02/27/2017 |
| Medicare PECOS PAC ID | 9335332006 |
|---|---|
| Medicare Enrollment ID | O20101026001116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295044204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2730 (Georgia) | Primary |
| Provider Name | Heather V Youngblood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902085830 PECOS PAC ID: 2264510551 Enrollment ID: I20080428000451 |
| Provider Name | Lori Jeansonne Ayling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649474867 PECOS PAC ID: 9931409711 Enrollment ID: I20151201000119 |
| Provider Name | Michelle Elizabeth Mcewen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023622016 PECOS PAC ID: 4880098243 Enrollment ID: I20210806000602 |
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