Provider Demographics
NPI:1306684493
Name:WAYSTONE THERAPY LLC
Entity type:Organization
Organization Name:WAYSTONE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:MILLS
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:678-353-6778
Mailing Address - Street 1:515 E CROSSVILLE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5861
Mailing Address - Country:US
Mailing Address - Phone:678-353-6778
Mailing Address - Fax:678-336-0154
Practice Address - Street 1:515 E CROSSVILLE RD STE 340
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5861
Practice Address - Country:US
Practice Address - Phone:678-353-6778
Practice Address - Fax:678-336-0154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty