LIFE SKILLS COMMUNITY CENTER INC (NPI# 1871100024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871100024 |
| Entity Type | Organization |
| Organization Name | LIFE SKILLS COMMUNITY CENTER INC |
| Practice Address |
2440 Sandy Plains Rd Ste 300 Marietta GA 30066-7217 |
| Mailing Address |
4925 Erin Rd Sw Atlanta GA 30331-7808 |
| Practice Telephone | 4049180908 |
| Mailing Telephone | 4049180908 |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | KEETH MILLER (OWNER/CEO) |
| Authorized Official Telephone | 4049180908 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4925 Erin Rd Sw, Atlanta, GA 303317808 | 4049180908 |
| Street Address |
2440 SANDY PLAINS RD STE 300 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30066-7217 |
| 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 |
| 1497094205 | Changing Phases Behavioral Support, Inc | Internal Medicine | 3655 Canton Rd Ste 201, Marietta, GA 30066 | 2013-02-14 |
| 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 |
| Find all providers in zip 30066 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376173658 | Marcuetta D. Sims | Psychologist | 2436 Wood Meadows Dr Sw, Marietta, GA 30064-4471 | 2020-01-25 |
| 1043740772 | John Acomb | Psychologist | 4743 Carmichael Chase Ne, Marietta, GA 30066-1473 | 2017-06-15 |
| 1679857171 | Michael Jay Manalo | Psychologist | 45 South Ave Se, Ste 100, Marietta, GA 30060-2539 | 2011-10-03 |
| 1447303524 | Sheri Michelle Siegel | Psychologist | 125 Church St Ne, Suite 210, Marietta, GA 30060-8638 | 2007-01-19 |
| 1699859876 | Nancy Ellen Reigle | Psychologist | 2627 Sandy Plains Rd, Suite 101, Marietta, GA 30066-4269 | 2006-10-25 |
| 1639264120 | Linda Pak Bruner | Psychologist | 1640 Powers Ferry Road Se, Building 9, Suite 100, The Anxiety & Stress Management Institute, Marietta, GA 30067-5491 | 2006-10-03 |
| 1306134564 | Tonette Robinson | Psychologist | 55 Whitcher St Ne Ste 420, Marietta, GA 30060-1171 | 2011-07-20 |
| 1710034723 | Christine K Beard | Psychologist | 2655 Dallas Hwy Sw, Suite 230, Marietta, GA 30064-2597 | 2007-01-04 |
| 1487742052 | Rebecca Andrea Beaton | Psychologist | 1640 Powers Ferry Rd Se, Building 9, Suite 100, Marietta, GA 30067-5491 | 2006-10-10 |
| 1588676654 | Susan Leslie Mayo | Psychologist | 1640 Powers Ferry Rd Se, Bldg. 17, Ste. 350, Marietta, GA 30067-5491 | 2006-08-13 |
| 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.