Provider Demographics
NPI:1386801454
Name:QUARELLS CONSULTING, P.C.
Entity type:Organization
Organization Name:QUARELLS CONSULTING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:QUARELLS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:770-403-3124
Mailing Address - Street 1:1850 LAKE PARK DRIVE SE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-7647
Mailing Address - Country:US
Mailing Address - Phone:770-403-3124
Mailing Address - Fax:770-739-7659
Practice Address - Street 1:1850 LAKE PARK DR SE STE 106
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7642
Practice Address - Country:US
Practice Address - Phone:770-403-3124
Practice Address - Fax:770-739-7659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002525103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000935426HMedicaid