Organization · NPI-2

Psychological Consultants Of Georgia PC

Community/Behavioral Health · Mableton, GA

NPI number1093555989
StatusActive
Last updated in NPPESMay 29, 2024

Details

NPI
1093555989
Entity type
Organization (NPI-2)
Legal business name
Psychological Consultants Of Georgia PC
Organization subpart
No
Enumeration date
May 29, 2024
Certification date
May 29, 2024
Last updated
May 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes
261QM0850X Clinic/Center, Adult Mental Health––

Practice location

5284 Floyd Rd Sw Unit 1216
Mableton, GA 30126-6109

Phone 404-936-2346

Mailing address

5284 Floyd Rd Sw Unit 1216
Mableton, GA 30126-6109

Authorized official

Carmine Costello
President
4049362346

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