Provider Demographics
NPI:1053700260
Name:SPECTRUM ANALYTIC CONSULTING LLC
Entity type:Organization
Organization Name:SPECTRUM ANALYTIC CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:K
Authorized Official - Last Name:STEELE-PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:678-974-2162
Mailing Address - Street 1:2788 FARMSTEAD RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-2620
Mailing Address - Country:US
Mailing Address - Phone:678-736-3250
Mailing Address - Fax:
Practice Address - Street 1:750 HAMMOND DR NE
Practice Address - Street 2:BLDG 16 STE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5532
Practice Address - Country:US
Practice Address - Phone:678-736-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16805893251C00000X, 251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health