| Premier Psychiatric And Psychotherapy Consulting, Llc | |
|
1430 Stephens Dr Ne Atlanta GA 30329-3716 | |
| (404) 245-6536 | |
| Not Available |
| Full Name | Premier Psychiatric And Psychotherapy Consulting, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1430 Stephens Dr Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Joe Botnick (CEO) |
| Authorized Official Contact | 4042456536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Psychiatric And Psychotherapy Consulting, Llc 1430 Stephens Dr Ne Atlanta GA 30329-3716 Ph: (404) 245-6536 | Premier Psychiatric And Psychotherapy Consulting, Llc 1430 Stephens Dr Ne Atlanta GA 30329-3716 Ph: (404) 245-6536 |
| NPI Number | 1134565062 |
|---|---|
| Provider Enumeration Date | 05/19/2013 |
| Last Update Date | 05/19/2013 |
| Medicare PECOS PAC ID | 3779727698 |
|---|---|
| Medicare Enrollment ID | O20130916000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134565062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CSW001895 (Georgia) | Primary |
| Provider Name | Yelta P Malone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306074877 PECOS PAC ID: 8426199415 Enrollment ID: I20100113000413 |
| Provider Name | Emily D Russ |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245468719 PECOS PAC ID: 2769517945 Enrollment ID: I20100325000468 |
| Provider Name | Iris Branch Cleveland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184904211 PECOS PAC ID: 7416124276 Enrollment ID: I20120420000311 |
| Provider Name | Dorothy F Eberhart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821369133 PECOS PAC ID: 1456514330 Enrollment ID: I20120514000530 |
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