Organization Active NPI

Ausborn Behavioral Care, PC

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1114196912
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
AUSBORN BEHAVIORAL CARE, PC
Practice address
2295 Parklake Drive, N.E.
Suite 545
Atlanta, GA 30345-2950
Phone
(770) 938-4616
Fax
(855) 932-4901
NPI assigned
Feb 26, 2008
Last updated
Aug 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Dr. Denella Lazenby-Ausborn, PSY.D.
Title
Vice President/Chief Financial Offi
Phone
(770) 938-4616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

2295 Parklake Drive, N.E.
Suite 545
Atlanta, GA 30345-2950

Mailing address

2295 Parklake Drive, N.E.
Suite 545
Atlanta, GA 30345-2950
Phone (770) 938-4616

National Provider Directory

National Provider Directory

Locations

2295 Parklake Dr NE
Ste 545
Atlanta, GA 30345
Phone (770) 938-4616

1456 McLendon Dr
Ste B
Decatur, GA 30033
Phone (650) 557-8347

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1114196912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 PARKLAKE DRIVE, N.E.",
            "address_2": "SUITE 545",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452950",
            "telephone_number": "770-938-4616",
            "fax_number": "855-932-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 PARKLAKE DRIVE, N.E.",
            "address_2": "SUITE 545",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452950",
            "telephone_number": "770-938-4616",
            "fax_number": "855-932-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSBORN BEHAVIORAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "LAZENBY-AUSBORN",
        "authorized_official_first_name": "DENELLA",
        "authorized_official_title_or_position": "VICE PRESIDENT/CHIEF FINANCIAL OFFI",
        "authorized_official_telephone_number": "770-938-4616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.