| Elysium Consulting Llc | |
|
800 Marcus St Se Atlanta GA 30316-1230 | |
| (678) 960-9207 | |
| (404) 228-3606 |
| Full Name | Elysium Consulting Llc |
|---|---|
| Speciality | Social Worker |
| Location | 800 Marcus St Se, Atlanta, Georgia |
| Authorized Official Name and Position | Maranda Randolph (OWNER) |
| Authorized Official Contact | 7702628344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elysium Consulting Llc 800 Marcus St Se Atlanta GA 30316-1230 Ph: () - | Elysium Consulting Llc 800 Marcus St Se Atlanta GA 30316-1230 Ph: (678) 960-9207 |
| NPI Number | 1679969133 |
|---|---|
| Provider Enumeration Date | 04/11/2015 |
| Last Update Date | 04/11/2015 |
| Medicare PECOS PAC ID | 6507187010 |
|---|---|
| Medicare Enrollment ID | O20150609003088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679969133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Maranda Randolph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982098521 PECOS PAC ID: 7315268828 Enrollment ID: I20150611003343 |
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