Affiliated Behavioral Medical Group
Organization Active NPI Adult Mental Health Clinic/Center · Stone Mountain, GA
NPI 1508039306 · NPPES record last updated Jul 11, 2008
Key facts
- NPI
- 1508039306
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Mental Health Clinic/Center 261QM0850X
- License
- SMC2007-021 (GA)
- Legal business name
- AFFILIATED BEHAVIORAL MEDICAL GROUP
- Practice address
- 1014 Main St
Stone Mountain, GA 30083-2944 - Phone
- (404) 784-2782
- NPI assigned
- Apr 12, 2008
- Organization subpart
- No
Authorized official
- Name
- Robin Michele Johnson, MD
- Title
- Affiliated Behavioral Medical Owner
- Phone
- (404) 784-2782
Practitioners 1
-
Robin Michele Johnson, M.D.
National Provider Directory
Locations
560 Saint Charles Ave NE
Atlanta, GA 30308
Phone (404) 873-0108
1014 Main St
Stone Mountain, GA 30083
Phone (404) 784-2782
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | SMC2007-021 | GA | Yes |
Addresses
Primary practice location
1014 Main St
Stone Mountain, GA 30083-2944
Mailing address
1014 Main St
Stone Mountain, GA 30083-2944
Phone (404) 784-2782
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.