NPIMap

Organization Active NPI

LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucker, GA
National Provider Identifier
1295953693
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
CP0000040003 Issued in GA
Legal business name
LDS FAMILY SERVICES
Practice address
4823 N Royal Atlanta Dr
Tucker, GA 30084-3806
Phone
(770) 939-2121
Fax
(770) 908-5784
NPI assigned
Apr 23, 2007
Organization subpart
Yes
Parent organization
LDS FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Christopher Young, LCSWNPI 1609925460
Title
Director
Phone
(770) 939-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CP0000040003 GA Primary

Addresses

Primary practice location

4823 N Royal Atlanta Dr
Tucker, GA 30084-3806

Mailing address

4823 N Royal Atlanta Dr
Tucker, GA 30084-3806
Phone (770) 939-2121

Other names 1

  • LDS Family Services Georgia Agency Doing business as

National Provider Directory

National Provider Directory
Part of
Robert D Smith PHD

Locations

4823 N Royal Atlanta Dr
Tucker, GA 30084
Phone (770) 939-2121

Practitioners & affiliated clinicians

Practitioners 11

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1295953693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4823 N ROYAL ATLANTA DR",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843806",
            "telephone_number": "770-939-2121",
            "fax_number": "770-908-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4823 N ROYAL ATLANTA DR",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843806",
            "telephone_number": "770-939-2121",
            "fax_number": "770-908-5784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDS FAMILY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LDS FAMILY SERVICES",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-939-2121",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "GA",
            "license": "CP0000040003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDS Family Services Georgia Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.