| Charting Your Course, Llc | |
|
1776 Century Blvd Ne Suite A Atlanta GA 30345-3397 | |
| (404) 579-1987 | |
| (770) 643-3944 |
| Full Name | Charting Your Course, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1776 Century Blvd Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Hamid Mirsalimi (OWNER) |
| Authorized Official Contact | 4045791987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charting Your Course, Llc 12 Norcross St Suite 200c Roswell GA 30075-7409 Ph: (404) 579-1987 | Charting Your Course, Llc 1776 Century Blvd Ne Suite A Atlanta GA 30345-3397 Ph: (404) 579-1987 |
| NPI Number | 1750597530 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 10/07/2010 |
| Medicare PECOS PAC ID | 9032247655 |
|---|---|
| Medicare Enrollment ID | O20100503000147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750597530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY002432 (Georgia) | Primary |
| Provider Name | Hamid Mirsalimi |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1205041100 PECOS PAC ID: 9335276435 Enrollment ID: I20100421000794 |
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