Preston Michael Elder, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003951 Issued in GA

Practice address

140 Decatur St SE
Suite 1053
Atlanta, GA 30303-3204

Phone

(404) 413-6221

Fax

(404) 413-6130

NPI assigned

Oct 1, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1174993299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 DECATUR ST SE",
            "address_2": "SUITE 1053",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033204",
            "telephone_number": "404-413-6221",
            "fax_number": "404-413-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 DECATUR ST SE",
            "address_2": "SUITE 1053",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033204",
            "telephone_number": "404-413-6221",
            "fax_number": "404-413-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "PRESTON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alesha Deshay Elbert
• Shady Mounir Eldaif, M.D.
• Courtney C Elder, M.D.
• Marian D Elder, RN,MSN,APRN
• Melanie Estelle Elder, LCSW-C
• Nora Adel Eldin
• Eldridge Podiatry and Diabetes Center, LLC
• Cheree Shantell Eldridge, DPM
• Eleanor Health Professional TX, PLLC
• Audrey Benita Eleby, RN

• 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 Oct 1, 2015; 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.