Gary Santavicca, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1224 Issued in GA

Practice address

340 Blvd NE
Ste 640
Atlanta, GA 30312

Phone

(404) 653-1117

Fax

(404) 880-0133

NPI assigned

Apr 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Florida College of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gary Santavicca, PH.D. and Associates

  • Psychologist
  • Atlanta, GA
  • NPI 1518171222
  Medicare reassignment NPD
• Elizabeth Newton, PSYD and Assoc Inc

  • Clinical Psychologist
  • Atlanta, GA
  • NPI 1972123883
  NPD (past)

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124080395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BLVD NE",
            "address_2": "STE 640",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "404-653-1117",
            "fax_number": "404-880-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BLVD NE",
            "address_2": "STE 640",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "404-653-1117",
            "fax_number": "404-880-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTAVICCA",
        "first_name": "GARY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00423178A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Santamarina, D.P.M.
• Santana Transitions MHT LLC
• Eric Willians Santana
• Marly Alexis Santana, LCSW
• Rafael Santana, M.D.
• Tara Santee, CPNP
• Carla Santiago Barbosa, PSYD
• Brian Santiago, LPC
• Carmencita C. Santiago, BSN, RN, OCN, CRNI
• Karhla Santiago, PHARM D

• 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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.