Provider Demographics
NPI:1962241950
Name:ANTROBUS CONSULTING, LLC
Entity type:Organization
Organization Name:ANTROBUS CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTROBUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-383-0644
Mailing Address - Street 1:1772 CHASEWOOD PARK LN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-4296
Mailing Address - Country:US
Mailing Address - Phone:404-402-2261
Mailing Address - Fax:
Practice Address - Street 1:707 WHITLOCK AVE SW STE C28
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4655
Practice Address - Country:US
Practice Address - Phone:678-383-0644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty