Provider Demographics
NPI:1609620608
Name:ROBERT MARCHANT
Entity type:Organization
Organization Name:ROBERT MARCHANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-464-6033
Mailing Address - Street 1:120 MLK SR HERITAGE TRL STE 105
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3411
Mailing Address - Country:US
Mailing Address - Phone:770-464-6033
Mailing Address - Fax:678-306-1861
Practice Address - Street 1:120 MLK SR HERITAGE TRL STE 105
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3411
Practice Address - Country:US
Practice Address - Phone:770-464-6033
Practice Address - Fax:678-306-1861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty