NPIMap

Organization Active NPI

Douglasville Psychological Outpatient Services

  • Community/Behavioral Health Agency
  • Douglasville, GA
National Provider Identifier
1073909198
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
LPC003228 Issued in GA
Legal business name
DOUGLASVILLE PSYCHOLOGICAL OUTPATIENT SERVICES
Practice address
8304 Office Park Dr
Douglasville, GA 30134-6935
Phone
(678) 838-9336
NPI assigned
Apr 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Authorized official

Name
Mrs. Michella Catherine JonesNPI 1902954423
Title
Licensed Professional Counselor
Phone
(678) 838-9336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LPC003228 GA Primary

Addresses

Primary practice location

8304 Office Park Dr
Douglasville, GA 30134-6935

Mailing address

8304 Office Park Dr
Douglasville, GA 30134-6935
Phone (678) 838-9336

National Provider Directory

National Provider Directory
Tax ID family
Douglasville Outpatient Psychological Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8304 Office Park Dr
Douglasville, GA 30134
Phone (678) 838-9336

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": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1073909198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8304 OFFICE PARK DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346935",
            "telephone_number": "678-838-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8304 OFFICE PARK DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346935",
            "telephone_number": "678-838-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLASVILLE PSYCHOLOGICAL OUTPATIENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MICHELLA",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "678-838-9336",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC003228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.