NPIMap

Organization Active NPI

United Psychology Center, LLC

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1063704542
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
UNITED PSYCHOLOGY CENTER, LLC
Practice address
2900 Chamblee Tucker Rd BLDG 16
Atlanta, GA 30341-4148
Phone
(770) 939-1288
Fax
(770) 212-2203
NPI assigned
May 3, 2011
Last updated
Oct 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Linda Lue
Title
Business Owner
Phone
(770) 939-1288

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

2900 Chamblee Tucker Rd BLDG 16
Atlanta, GA 30341-4148

Mailing address

2900 Chamblee Tucker Rd BLDG 16
Atlanta, GA 30341-4148
Phone (770) 939-1288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130125000418 GA Part B Supplier - Clinic/Group Practice 0648424796 Receives reassigned benefits from 36 practitioners
Practice locations: Atlanta, GA
O20170403000640 SC Part B Supplier - Clinic/Group Practice 0648424796 Practice locations: Ridgeway, SC

National Provider Directory

National Provider Directory

Locations

2849 Henderson Mill Rd
#B
Atlanta, GA 30341
Phone (770) 939-1288

213 Tanglewood Ct
Ridgeway, SC 29130
Phone (770) 939-1288

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1063704542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CHAMBLEE TUCKER RD BLDG 16",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414148",
            "telephone_number": "770-939-1288",
            "fax_number": "770-212-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CHAMBLEE TUCKER RD BLDG 16",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414148",
            "telephone_number": "770-939-1288",
            "fax_number": "770-212-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED PSYCHOLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "LUE",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "770-939-1288"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.