NPIMap

Organization Active NPI

Georgia Behavioral Wellness Center LLC

  • Psychiatry Physician
  • Newnan, GA
National Provider Identifier
1376915280
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GEORGIA BEHAVIORAL WELLNESS CENTER LLC
Practice address
2511 Highway 34 E
Newnan, GA 30265-2309
Phone
(678) 369-6910
NPI assigned
Oct 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Authorized official

Name
Ashley Tagtachian
Title
Ceo
Phone
(770) 548-2589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2511 Highway 34 E
Newnan, GA 30265-2309

Mailing address

5175 Falcon Chase LN
Atlanta, GA 30342-2155
Phone (770) 548-2589

National Provider Directory

National Provider Directory

Locations

125 Governors Sq
Ste B
Peachtree City, GA 30269
Phone (678) 423-5500

Practitioners & affiliated clinicians

Practitioners 4

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": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1376915280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 FALCON CHASE LN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422155",
            "telephone_number": "770-548-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 HIGHWAY 34 E",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652309",
            "telephone_number": "678-369-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA BEHAVIORAL WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "TAGTACHIAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-548-2589"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.