| Executive Presence Solutions | |
|
2801 Buford Hwy Ne Ste T80 Brookhaven GA 30329-2147 | |
| (404) 430-0859 | |
| Not Available |
| Full Name | Executive Presence Solutions |
|---|---|
| Speciality | Counselor |
| Location | 2801 Buford Hwy Ne Ste T80, Brookhaven, Georgia |
| Authorized Official Name and Position | Chad Husted (OWNER) |
| Authorized Official Contact | 7706399657 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Presence Solutions 2801 Buford Hwy Ne Ste T80 Brookhaven GA 30329-2147 Ph: (404) 430-0859 | Executive Presence Solutions 2801 Buford Hwy Ne Ste T80 Brookhaven GA 30329-2147 Ph: (404) 430-0859 |
| NPI Number | 1538865860 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 04/10/2025 |
| Certification Date | 04/10/2025 |
| Medicare PECOS PAC ID | 9830533496 |
|---|---|
| Medicare Enrollment ID | O20240222000907 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538865860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | () | Secondary |
| 101YM0800X | Counselor - Mental Health | () | Secondary |
| 101YP2500X | Counselor - Professional | () | Primary |
| Provider Name | Chad R Husted |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477268225 PECOS PAC ID: 7719321371 Enrollment ID: I20240222001241 |
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