Irene Sele Agedah
Individual provider Active NPI Psychiatry Physician · McDonough, GA
NPI 1104715283 · NPPES record last updated Jul 2, 2025
Key facts
- NPI
- 1104715283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 250564 (GA)
- Practice address
- 216 Windy Cir
McDonough, GA 30253-8000 - Phone
- (678) 938-7038
- NPI assigned
- Jul 2, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 250564 | GA | MD | Addiction Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 250564 | GA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 250564 | GA | |
| Psychiatry Physician | 2084P0800X | 250564 | GA | Yes |
Addresses
Primary practice location
216 Windy Cir
McDonough, GA 30253-8000
Mailing address
216 Windy Cir
McDonough, GA 30253-8000
Phone (678) 938-7038
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All providers in McDonough, GA · Psychiatry Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.