NPIMap

Organization Active NPI

Personal Recovery Network LLC

  • Psychologist
  • Marietta, GA
National Provider Identifier
1023356458
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PERSONAL RECOVERY NETWORK LLC
Practice address
1640 Powers Ferry Rd SE
Building 9, Suite 100
Marietta, GA 30067-5491
Phone
(770) 953-0080
Fax
(770) 953-0031
NPI assigned
Jan 18, 2013
Organization subpart
Yes
Parent organization
PERSONAL RECOVERY NETWORK LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashley Nichols Tagtachian, MBA
Title
Chief Executive Officer
Phone
(770) 548-2589

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

1640 Powers Ferry Rd SE
Building 9, Suite 100
Marietta, GA 30067-5491

Mailing address

1640 Powers Ferry Rd SE
Building 9, Suite 100
Marietta, GA 30067-5491
Phone (770) 953-0080

Other names 1

  • The Anxiety & Stress Management Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Personal Recovery Network9 organizations share this tax ID, including this one
Part of
Personal Recovery Network

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023356458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "address_2": "BUILDING 9, SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-953-0080",
            "fax_number": "770-953-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "address_2": "BUILDING 9, SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-953-0080",
            "fax_number": "770-953-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL RECOVERY NETWORK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERSONAL RECOVERY NETWORK LLC",
        "enumeration_date": "2013-01-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TAGTACHIAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "NICHOLS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "770-548-2589",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Anxiety & Stress Management Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.