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Contact Information

ATLANTA CENTER FOR FAMILY WELLNESS, LLC
1401 PEACHTREE ST NE STE 210
ATLANTA, GA30309-3000
 Phone: 404-550-9981
 Fax: 404-475-4880
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ATLANTA CENTER FOR FAMILY WELLNESS, LLC

NPI Number 1215103767
LBN Legal business name ATLANTA CENTER FOR FAMILY WELLNESS, LLC
Authorized official NATHANIEL WILSON - (PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 05/05/2008
Last updated 03/27/2013 - About 13 years ago
Identifiers
GA License # PSY002857
GA Medicaid 624392123A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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