Provider Demographics
NPI:1487233433
Name:C.E.O. PROFESSIONAL SERVICES, LLC
Entity type:Organization
Organization Name:C.E.O. PROFESSIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ OWNER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAGAEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-994-6304
Mailing Address - Street 1:PO BOX 3037
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-0052
Mailing Address - Country:US
Mailing Address - Phone:678-383-7093
Mailing Address - Fax:912-539-6565
Practice Address - Street 1:3841 HOLCOMB BRIDGE RD STE 400
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2205
Practice Address - Country:US
Practice Address - Phone:404-994-6304
Practice Address - Fax:912-539-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty