NPIMap

Organization Active NPI

Imogene Hayes Brodsky LCSW LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Marietta, GA
National Provider Identifier
1972359537
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
IMOGENE HAYES BRODSKY LCSW LLC
Practice address
4919 Marlos Dr NE
Marietta, GA 30066-6919
Phone
(678) 993-3767
NPI assigned
Apr 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Imogene Brodsky, LCSWNPI 1225190796
Title
Owner
Phone
(678) 993-3767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4919 Marlos Dr NE
Marietta, GA 30066-6919

Mailing address

4919 Marlos Dr NE
Marietta, GA 30066-6919
Phone (678) 993-3767

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1972359537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 MARLOS DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666919",
            "telephone_number": "678-993-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4919 MARLOS DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666919",
            "telephone_number": "678-993-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMOGENE HAYES BRODSKY LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "BRODSKY",
        "authorized_official_first_name": "IMOGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-993-3767",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 25, 2024; 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.