Libby Tannenbaum LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PSY2710 Issued in GA

Legal business name

LIBBY TANNENBAUM LLC

Practice address

11755 Pointe PL
Suite a-1
Roswell, GA 30076-4656

Phone

(404) 281-6477

NPI assigned

Apr 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Libby Tannenbaum, PH.D.

Title

Clinical Psychologist

Phone

(404) 281-6477

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1184079030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11755 POINTE PL",
            "address_2": "SUITE A-1",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764656",
            "telephone_number": "404-281-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11755 POINTE PL",
            "address_2": "SUITE A-1",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764656",
            "telephone_number": "404-281-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBBY TANNENBAUM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "TANNENBAUM",
        "authorized_official_first_name": "LIBBY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "404-281-6477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "PSY2710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.