Provider Demographics
NPI:1487734372
Name:ATLANTA FAMILY COUNSELING CENTER, INC
Entity type:Organization
Organization Name:ATLANTA FAMILY COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-513-8988
Mailing Address - Street 1:190 CAMDEN HILL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-2448
Mailing Address - Country:US
Mailing Address - Phone:770-513-8988
Mailing Address - Fax:770-513-2565
Practice Address - Street 1:190 CAMDEN HILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-2448
Practice Address - Country:US
Practice Address - Phone:770-513-8988
Practice Address - Fax:770-513-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002598101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty