Wellstar Neuropsychology, LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

WELLSTAR NEUROPSYCHOLOGY, LLC

Practice address

677 Church St NE
Marietta, GA 30060-1101

Phone

(770) 793-6695

Fax

(770) 793-7997

NPI assigned

May 2, 2008

Last updated

Feb 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Nicole Ashe

Title

Executive Director of Finance

Phone

(770) 792-5261

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1083880744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-6695",
            "fax_number": "770-793-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-6695",
            "fax_number": "770-793-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR NEUROPSYCHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "ASHE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "770-792-5261",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.