Individual provider Active NPI

Joelle Bryk, PSYD

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1053930271
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY004565 Issued in GA
Practice address
1605 Chantilly Dr NE
Suite 110
Atlanta, GA 30324-3267
Phone
(404) 785-5437
Fax
(404) 785-7874
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY004565 GA Primary

Addresses

Primary practice location

1605 Chantilly Dr NE
Suite 110
Atlanta, GA 30324-3267

Mailing address

1605 Chantilly Dr NE
Suite 110
Atlanta, GA 30324-3267
Phone (404) 785-5437

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY004565GAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1053930271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 CHANTILLY DR NE",
            "address_2": "SUITE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243267",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 CHANTILLY DR NE",
            "address_2": "SUITE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243267",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYK",
        "first_name": "JOELLE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1605 Chantilly Dr NE",
            "address_2": "Suite 110",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303243267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.