Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Changing Phases Behavioral Support, Inc

Organization Internal Medicine Physician · NPI 1497094205

Changing Phases Behavioral Support, Inc is an Internal Medicine Physician in Marietta, Georgia. Licensed in Georgia. Registered with an NPI since 2013.

Licensed in
GA
In the registry since
2013
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3655 Canton Rd Ste 201
Marietta, GA 30066
Phone: (707) 261-1627
Fax: (707) 702-5966
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X
Internal Medicine Physician Taxonomy 207R00000X · Licence 25937 (GA)

Record details

NPI number1497094205
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mya Cullins — Vice President · (336) 268-6469
NPI enumeratedFebruary 14, 2013
Last updated in NPPESAugust 17, 2018
Mailing address3655 Canton Rd, Marietta, GA 30066-2690

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