Out of the Box, Counseling, Coaching, and Consulting

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

OUT OF THE BOX, COUNSELING, COACHING, AND CONSULTING

Practice address

10475 Medlock Bridge Rd Ste 205
Duluth, GA 30097-4446

Phone

(678) 379-3781

Fax

(770) 232-1326

NPI assigned

Jan 31, 2022

Organization subpart

No

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

Authorized official

Name

Bertrina West, PHD

Title

Clinical Director

Phone

(678) 379-3781

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1053064022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10475 MEDLOCK BRIDGE RD STE 205",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974446",
            "telephone_number": "678-379-3781",
            "fax_number": "770-232-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 MEDLOCK BRIDGE RD STE 205",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974446",
            "telephone_number": "678-379-3781",
            "fax_number": "770-232-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUT OF THE BOX, COUNSELING, COACHING, AND CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "BERTRINA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "678-379-3781",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Duluth, GA
• Providers in Duluth, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.