Georgia Pediatric Psychology, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2999 Issued in GA

Legal business name

GEORGIA PEDIATRIC PSYCHOLOGY, INC.

Practice address

750 Hammond Dr
BLDG 1, Ste 100
Atlanta, GA 30328-5532

Phone

(678) 999-3477

Fax

(678) 999-3567

NPI assigned

Nov 2, 2013

Organization subpart

No

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

Authorized official

Name

Avital K Cohen, PSY.D.

Title

Co-Owner/Clinical Psychologist

Phone

(678) 999-3477

Specialties & licenses 2

Addresses

Other names 1

• GPP Other name

Locations

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1104255959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 HAMMOND DR",
            "address_2": "BLDG 1, STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285532",
            "telephone_number": "678-999-3477",
            "fax_number": "678-999-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HAMMOND DR",
            "address_2": "BLDG 1, STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285532",
            "telephone_number": "678-999-3477",
            "fax_number": "678-999-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PEDIATRIC PSYCHOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "AVITAL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CO-OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "678-999-3477",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "3672",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "2999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GPP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Georgia Palliative Care Services LLC
• Georgia Parent Support Network, Inc.
• Georgia Pediatric Pulmonology Associates, P.C.
• Georgia Perinatal Centers, Inc.
• Georgia PHS PC
• Georgia Physicians of Cardiology, LLC
• Georgia Plastic Surgery

• Clinical Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.