NPIMap

Organization Active NPI

Personal Recovery Network LLC

Doing business as Georgia Behavioral Health Professionals

  • Psychiatry Physician
  • Johns Creek, GA
National Provider Identifier
1912366014
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
6385 McGinnis Ferry Rd
Suite 202
Johns Creek, GA 30005-3621
Phone
(470) 482-6508
Fax
(770) 476-9750
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 CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

6385 McGinnis Ferry Rd
Suite 202
Johns Creek, GA 30005-3621

Mailing address

10090 Medlock Bridge
Ste 110
Johns Creek, GA 30097
Phone (470) 482-6508

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

10090 Medlock Bridge Rd
Ste 110
Johns Creek, GA 30097
Phone (470) 482-6508

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.

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

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": "1912366014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10090 MEDLOCK BRIDGE",
            "address_2": "STE 110",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "470-482-6508",
            "fax_number": "770-476-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6385 MCGINNIS FERRY RD",
            "address_2": "SUITE 202",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300053621",
            "telephone_number": "470-482-6508",
            "fax_number": "770-476-9750"
        }
    ],
    "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Behavioral Health Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johns Creek, 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.