Provider Demographics
NPI:1427948439
Name:COMMON GROUND THERAPY
Entity type:Organization
Organization Name:COMMON GROUND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:YANLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TSO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-745-4602
Mailing Address - Street 1:2376 CANDLER RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-6406
Mailing Address - Country:US
Mailing Address - Phone:850-745-4602
Mailing Address - Fax:
Practice Address - Street 1:2376 CANDLER RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-6406
Practice Address - Country:US
Practice Address - Phone:850-745-4602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health