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

LicenseStateTypeSpecialty
250564GAMDAddiction Psychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in McDonough, GA

All providers in McDonough, GA · Psychiatry Physician in Georgia

Sources for this page

Verify at the official NPI Registry.