CHANGING PHASES BEHAVIORAL SUPPORT, INC (NPI# 1497094205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497094205 |
| Entity Type | Organization |
| Organization Name | CHANGING PHASES BEHAVIORAL SUPPORT, INC |
| Practice Address |
3655 Canton Rd Ste 201 Marietta GA 30066 |
| Mailing Address |
3655 Canton Rd Marietta GA 30066-2690 |
| Practice Telephone | 7072611627 |
| Practice Fax Number | 7077025966 |
| Mailing Telephone | 7707261162 |
| Mailing Fax Number | 7707025966 |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | MRS. MYA S CULLINS (VICE PRESIDENT) |
| Authorized Official Telephone | 3362686469 |
| Authorized Official Credential | LCASA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 25937 | GA | Allopathic & Osteopathic Physicians |
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
3655 CANTON RD STE 201 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801380100 | Mallory Cary | Social Worker | 3655 Canton Rd Ste 201, Marietta, GA 30066-7614 | 2018-06-20 |
| 1639668957 | Errick Thornton | Counselor | 3655 Canton Rd Ste 201, Marietta, GA 30066-7614 | 2018-05-02 |
| 1174012579 | Gina Marie Williams | Counselor | 3655 Canton Rd Ste 201, Marietta, GA 30066-7614 | 2018-05-02 |
| 1457840852 | Delacia Gail | Counselor | 3655 Canton Rd Ste 201, Marietta, GA 30066-7614 | 2018-05-02 |
| 1396234712 | Kimberly Mcfadden | Licensed Practical Nurse | 3655 Canton Rd Ste 201, Marietta, GA 30066-7614 | 2018-05-02 |
| 1811442726 | Courtney Brooke Pollard | Registered Nurse | 3655 Canton Rd Ste 201, Marietta, GA 30066-7614 | 2016-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598253684 | Comfort Community Center, LLC | Skilled Nursing Facility | 2440 Sandy Plains Road, Blvd 21, Suite 100, Marietta, GA 30066 | 2018-04-25 |
| 1538681994 | Passionate Care | In Home Supportive Care | 1110 Renfro Ln., Marietta, GA 30066 | 2017-07-07 |
| 1437510443 | Steven Caras | Internal Medicine | 2682 Bonaire Terrace, Marietta, GA 30066 | 2016-03-18 |
| 1275918781 | Latifat Bolajoko Asemota | Nurse Practitioner | 410 Nottingham Dr, Marietta, GA 30066 | 2015-07-26 |
| 1659618916 | Alison Nicole Sims | Occupational Therapist | 2465 Canopy Drive, Marietta, GA 30066 | 2013-01-07 |
| 1790044907 | Antoine Jose Davenport | Massage Therapist | 4686 Jamerson Creek Dr, Marietta, GA 30066 | 2012-05-08 |
| 1174898548 | Angel Elizabeth Nofziger | Nurse Practitioner | 3750 Palladian Village Dr Ste 300, Marietta, GA 30066 | 2012-03-18 |
| 1912298019 | Nancy Jean Slack | Pharmacist | 2833 Canton Road, Marietta, GA 30066 | 2011-04-22 |
| 1336456078 | Mario B Miller Sr. | Chiropractor | 50 Barrett Parkway, Suite 3005#126, Marietta, GA 30066 | 2010-09-01 |
| 1619121837 | America's Best Contacts & Eyeglasses | Technician/Technologist | 50 Ernest W. Barrett Pkwy, Ste. 1500, Marietta, GA 30066 | 2008-11-14 |
| Find all providers in zip 30066 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346729126 | Cope Behavioral Health LLC | Community/Behavioral Health | 2470 Windy Hill Rd Se Ste 247, Marietta, GA 30067-8619 | 2018-08-13 |
| 1770073488 | Greg Griffin, LLC | Community/Behavioral Health | 3827 Roswell Rd Ste 100c, Marietta, GA 30062-6297 | 2018-05-17 |
| 1982146569 | Positive Reinforcement By Zeus Frazier,inc. | Community/Behavioral Health | 3095 Milford Chase Sw, Marietta, GA 30008-6883 | 2016-11-14 |
| 1710341011 | Infinity Counseling LLC | Community/Behavioral Health | 2420 Wood Meadows Dr Sw, Marietta, GA 30064-4471 | 2016-04-12 |
| 1598148090 | Better Story Counseling, LLC | Community/Behavioral Health | 4985 Lower Roswell Rd, Suite 200, Marietta, GA 30068-4337 | 2015-07-01 |
| 1104256437 | Atlanta Psychoterapy and Consulting, LLC | Community/Behavioral Health | 1647 Lower Roswell Rd, Marietta, GA 30068-3336 | 2013-11-22 |
| 1770827578 | Journey for Learning Independence for Empowerment | Community/Behavioral Health | 1316 Westward Dr Sw, Marietta, GA 30008-4028 | 2012-11-16 |
| 1992057962 | Highland Rivers Community Service Board | Community/Behavioral Health | 3671 Shallowford Rd, Marietta, GA 30062-4185 | 2012-10-15 |
| 1285997551 | Master Plan Christian Counseling | Community/Behavioral Health | 133 Johnson Ferry Rd, Suite 110, Marietta, GA 30068-4923 | 2012-06-20 |
| 1336406545 | Rts Services Unlimited Inc | Community/Behavioral Health | 3823 Roswell Rd Ste 102, Marietta, GA 30062 | 2012-04-12 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.