Provider Demographics
NPI:1285443978
Name:KAIBZHANOV, ALMAT
Entity type:Individual
Prefix:
First Name:ALMAT
Middle Name:
Last Name:KAIBZHANOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 CHINQUAPIN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-4896
Mailing Address - Country:US
Mailing Address - Phone:754-226-7779
Mailing Address - Fax:
Practice Address - Street 1:3133 MAPLE DR NE STE 240
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2509
Practice Address - Country:US
Practice Address - Phone:404-974-3660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0094061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical