Organization Active NPI

Juniors Society Inc

  • Intellectual & Developmental Disabilities Psychologist
  • Decatur, GA
National Provider Identifier
1184590945
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Legal business name
JUNIORS SOCIETY INC
Practice address
811 Creste Dr
Decatur, GA 30035-4135
Phone
(478) 461-0023
NPI assigned
Oct 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Richard Jackson Jr.NPI 1144192568
Title
Ceo/Program Director
Phone
(478) 461-0023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TM1800X Primary

Addresses

Primary practice location

811 Creste Dr
Decatur, GA 30035-4135

Mailing address

811 Creste Dr
Decatur, GA 30035-4135
Phone (478) 461-0023

National Provider Directory

National Provider Directory
Tax ID family
Juniors Society Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1184590945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 CRESTE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354135",
            "telephone_number": "478-461-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CRESTE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354135",
            "telephone_number": "478-461-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNIORS SOCIETY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "478-461-0023",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.