Mayo Psychological Services, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1582 Issued in GA

Legal business name

MAYO PSYCHOLOGICAL SERVICES, INC.

Practice address

1640 Powers Ferry Rd SE
BLDG. 17, Ste. 350
Marietta, GA 30067-5491

Phone

(770) 956-9212

Fax

(770) 956-9211

NPI assigned

Jan 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Susan Leslie Mayo, PH.D.

Title

President

Phone

(770) 956-9212

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1134367378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "address_2": "BLDG. 17, STE. 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-956-9212",
            "fax_number": "770-956-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "address_2": "BLDG. 17, STE. 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-956-9212",
            "fax_number": "770-956-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-956-9212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1582",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "1582",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keisha Tenell Mayer, LPC
• Stephen D Mayes, HAD
• Anne Scarlett Mayfield, LAPC
• William Rodger Mayfield, M.D.
• Susan Harbison Mayne, PT
• Susan Leslie Mayo, PH.D.
• Philip Tyler Mayotte, PHARM. D.
• Kenisha Mays
• Nitin N Mayur, MD
• Janusz Mazon, D.C.

• Clinical Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.

Verify at the official NPI Registry.