Provider Demographics
NPI:1750101010
Name:ACUTE SOCIAL ADVANCEMENT LLC
Entity type:Organization
Organization Name:ACUTE SOCIAL ADVANCEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:470-823-2287
Mailing Address - Street 1:3169 SPICY CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:STONECREST
Mailing Address - State:GA
Mailing Address - Zip Code:30038-7160
Mailing Address - Country:US
Mailing Address - Phone:470-823-2287
Mailing Address - Fax:470-377-6528
Practice Address - Street 1:3169 SPICY CEDAR LN
Practice Address - Street 2:
Practice Address - City:STONECREST
Practice Address - State:GA
Practice Address - Zip Code:30038-7160
Practice Address - Country:US
Practice Address - Phone:470-823-2287
Practice Address - Fax:470-377-6528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2025-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty