National Provider Identifier Database

KENNESAW STATE UNIVERSITY HEALTH CLINIC
Adult Mental Health

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.


Contact Information

KENNESAW STATE UNIVERSITY HEALTH CLINIC
1000 CHASTAIN RD NW
HOUSE 52
KENNESAW, GA30144-5588
Phone: 770-423-6644
Fax:
Website:
Specialty Taxonomy Code
* Adult Mental Health 261QM0850X
Student Health 261QS1000X

* Indicates primary specialty

NPI Profile & details for KENNESAW STATE UNIVERSITY HEALTH CLINIC

NPI Number 1831426931
Legal business name
LBN
KENNESAW STATE UNIVERSITY HEALTH CLINIC
Authorized official ANNE NICHOLS - (HEALTH CLINIC DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 11/10/2009
Last updated 11/10/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: RN057224

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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