Provider Demographics
NPI:1053194720
Name:MARIGOLD THERAPY, LLC
Entity type:Organization
Organization Name:MARIGOLD THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILHOIT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-270-3281
Mailing Address - Street 1:3715 NORTHSIDE PKWY NW
Mailing Address - Street 2:BLDG 100, STE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:404-954-1480
Mailing Address - Fax:
Practice Address - Street 1:3715 NORTHSIDE PKWY NW
Practice Address - Street 2:BLDG 100, STE 500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:404-954-1480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health