Organization Active NPI

Christian Counseling and Psychological Services

  • Clinical Psychologist
  • Suwanee, GA
National Provider Identifier
1053575381
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
001411 Issued in GA
Legal business name
CHRISTIAN COUNSELING AND PSYCHOLOGICAL SERVICES
Practice address
2910 B Horizon Park Drive
Suwanee, GA 30024
Phone
(770) 271-8989
Fax
(770) 932-8297
NPI assigned
Jul 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Scott Duncan, PSY.D.NPI 1275608770
Title
Licensed Psychologist
Phone
(404) 434-1903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 001411 GA Primary

Addresses

Primary practice location

2910 B Horizon Park Drive
Suwanee, GA 30024

Mailing address

2910 B Horizon Park Drive
Suwanee, GA 30024
Phone (770) 271-8989

Other identifiers 1

IdentifierTypeStateIssuer
00536445BMedicaidGA

National Provider Directory

National Provider Directory

Locations

2910 Horizon Park Dr
Ste B
Suwanee, GA 30024
Phone (770) 271-8989

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1053575381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 B HORIZON PARK DRIVE",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "770-271-8989",
            "fax_number": "770-932-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 B HORIZON PARK DRIVE",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "770-271-8989",
            "fax_number": "770-932-8297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING AND PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "404-434-1903",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "001411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00536445B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.