Provider Demographics
NPI:1043814924
Name:TALK FORWARD, LLC
Entity type:Organization
Organization Name:TALK FORWARD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-969-5247
Mailing Address - Street 1:1028 PARK MANOR TER NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1455
Mailing Address - Country:US
Mailing Address - Phone:404-969-5247
Mailing Address - Fax:
Practice Address - Street 1:1028 PARK MANOR TER NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1455
Practice Address - Country:US
Practice Address - Phone:404-969-5247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health