CG&D Addiction Services of Georgia

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

044673D Issued in GA

Legal business name

CG&D ADDICTION SERVICES OF GEORGIA

Practice address

4540 Memorial Dr
BLDG D
Decatur, GA 30032-1499

Phone

(404) 292-8175

Fax

(404) 292-8180

NPI assigned

Jul 14, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Theresa G. Cooper, LPC, CASAC

Title

Program Director/Ny

Phone

(631) 691-0769

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1437313947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 MEMORIAL DR",
            "address_2": "BLDG D",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321499",
            "telephone_number": "404-292-8175",
            "fax_number": "404-292-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 MEMORIAL DR",
            "address_2": "BLDG D",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300321499",
            "telephone_number": "404-292-8175",
            "fax_number": "404-292-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CG&D ADDICTION SERVICES OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR/NY",
        "authorized_official_telephone_number": "631-691-0769",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, CASAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "044673D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Centerwell Senior Primary Care Ga PC
• Cep America LLC
• Cerebrofit LLC
• Myrna Cervetti, NCC
• Carolyn Ceto- Koumandarakis, LCSW
• CG&D Addiction Services of Georgia, Inc.
• Shikha Rebecca Chacko, M.D.
• Talita Chacko
• Alice M Chae, MD
• Jyothsna S Challa, PA-C

• Community/Behavioral Health Agency in Decatur, GA
• Providers in Decatur, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.