Active NPI
Virginia Sutton Wood, PSY.D.
- Clinical Psychologist
- Woodstock, GA
National Provider Identifier
1104983410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2325
- Practice address
- 240 Creekstone RDG
Woodstock, GA 30188-3732 - Phone
- (404) 414-8086
- Fax
- (678) 392-3863
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2325 | GA | Primary |
Addresses
Primary practice location
240 Creekstone RDG
Woodstock, GA 30188-3732
Mailing address
240 Creekstone RDG
Woodstock, GA 30188-3732
Phone (404) 414-8086
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2325 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1104983410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 CREEKSTONE RDG",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301883732",
"telephone_number": "404-414-8086",
"fax_number": "678-392-3863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 CREEKSTONE RDG",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301883732",
"telephone_number": "404-414-8086",
"fax_number": "678-392-3863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "VIRGINIA",
"middle_name": "SUTTON",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "2325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.