NPIMap

Organization Active NPI

WBC Georgia LLC

  • Adult Mental Health Clinic/Center
  • Atlanta, GA
National Provider Identifier
1235674375
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
WBC GEORGIA LLC
Practice address
4536 Barclay Dr
Atlanta, GA 30338-7145
Phone
(770) 458-8711
NPI assigned
Dec 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Authorized official

Name
Dr. Stuart Koman, PHD
Title
Ceo/President
Phone
(781) 647-6767

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Psychiatric Residential Treatment Facility 323P00000X

Addresses

Primary practice location

4536 Barclay Dr
Atlanta, GA 30338-7145

Mailing address

51 Sawyer Rd
Waltham, MA 02453-3448

National Provider Directory

National Provider Directory

Locations

4536 Barclay Dr
Dunwoody, GA 30338
Phone (770) 458-8711

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1235674375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 SAWYER RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 BARCLAY DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303387145",
            "telephone_number": "770-458-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WBC GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "KOMAN",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "781-647-6767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.