Safeway Behavioral Health - Southeast, P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SAFEWAY BEHAVIORAL HEALTH - SOUTHEAST, P.C.

Practice address

1101 Bombay LN
Roswell, GA 30076-5832

Phone

(678) 349-2128

Fax

(404) 393-0138

NPI assigned

Dec 23, 2024

Organization subpart

No

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

Authorized official

Name

Josefina Bates, LCSW

Title

Owner

Phone

(678) 349-2128

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1043028962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765832",
            "telephone_number": "678-349-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765832",
            "telephone_number": "678-349-2128",
            "fax_number": "404-393-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFEWAY BEHAVIORAL HEALTH - SOUTHEAST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "JOSEFINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-349-2128",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell L. Sabrin, M.D.
• Sabrina D. Harrison, M.D., P.C.
• Suvidha Sachdeva, DDS
• Suzanne Sacks
• Armita Safaie
• Sage Dental Group of Georgia, LLC
• Bradley Richard Saindon, CRNA
• Saranyadevi Sakthivadivel, DMD
• Samantha Rose Salerno
• Ashar Salman, M.D.

• Mental Health Counselor in Roswell, GA
• Providers in Roswell, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.