Provider Demographics
NPI:1992174015
Name:A WHOLISTIC APPROACH, LLC
Entity type:Organization
Organization Name:A WHOLISTIC APPROACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:QUINLAIND
Authorized Official - Last Name:BAILEY BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-867-8217
Mailing Address - Street 1:2777 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-4054
Mailing Address - Country:US
Mailing Address - Phone:678-831-2810
Mailing Address - Fax:770-989-1086
Practice Address - Street 1:2777 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-4054
Practice Address - Country:US
Practice Address - Phone:678-831-2810
Practice Address - Fax:770-989-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW 4117251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10270G1151Medicare PIN