Gwinnett Psychology, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY0003641 Issued in GA

Legal business name

GWINNETT PSYCHOLOGY, LLC

Practice address

1805 Herrington Rd
BLDG. 2
Lawrenceville, GA 30043-7987

Phone

(507) 722-2402

Fax

(770) 962-1886

NPI assigned

Sep 24, 2014

Last updated

Sep 24, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Cassin Cole-Straub, PSY.D.NPI 1548513963

Title

Organizer/Psychologist

Phone

(507) 722-2402

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cassin Cole-Straub, PSY.D.

  • Psychologist
  • Lawrenceville, GA
  • NPI 1548513963
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1013319847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD",
            "address_2": "BLDG. 2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437987",
            "telephone_number": "507-722-2402",
            "fax_number": "770-962-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD",
            "address_2": "BLDG. 2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437987",
            "telephone_number": "507-722-2402",
            "fax_number": "770-962-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT PSYCHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "COLE-STRAUB",
        "authorized_official_first_name": "CASSIN",
        "authorized_official_title_or_position": "ORGANIZER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "507-722-2402",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY0003641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.