NPIMap

Organization Active NPI

Personal Recovery Network LLC

Doing business as Georgia Behavioral Health Professionals

  • Psychiatry Physician
  • Marietta, GA
National Provider Identifier
1831558931
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PERSONAL RECOVERY NETWORK LLC
Doing business as
Georgia Behavioral Health Professionals
Practice address
1640 Powers Ferry Rd SE
BLDG 9 Suite 330
Marietta, GA 30067-5491
Phone
(678) 831-0608
Fax
(678) 831-0564
NPI assigned
Feb 17, 2016
Last updated
Aug 9, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
PERSONAL RECOVERY NETWORK LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Authorized official

Name
Mrs. Ashley Nichols Tagtachian
Title
Administrator
Phone
(770) 548-2589

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1640 Powers Ferry Rd SE
BLDG 9 Suite 330
Marietta, GA 30067-5491

Mailing address

1640 Powers Ferry Rd SE
BLDG 9 Suite 330
Marietta, GA 30067-5491
Phone (678) 831-0608

Other names 1

  • Georgia Behavioral Health Professionals Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Personal Recovery Network9 organizations share this tax ID, including this one
Part of
Personal Recovery Network

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1640 Powers Ferry Rd SE
Bldg 9
Marietta, GA 30067
Phone (770) 953-0080

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502236800000",
    "number": "1831558931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "address_2": "BLDG 9 SUITE 330",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "678-831-0608",
            "fax_number": "678-831-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "address_2": "BLDG 9 SUITE 330",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "678-831-0608",
            "fax_number": "678-831-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL RECOVERY NETWORK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERSONAL RECOVERY NETWORK LLC",
        "enumeration_date": "2016-02-17",
        "last_updated": "2017-08-09",
        "status": "A",
        "authorized_official_last_name": "TAGTACHIAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "NICHOLS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-548-2589",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Behavioral Health Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; 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.