Individual provider Active NPI

Elaine Eassa, PH.D.

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1184794778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002323 Issued in GA
Practice address
1827 Powers Ferry Rd SE
BLDG 22 Ste 200
Atlanta, GA 30339-5621
Phone
(770) 953-4744
Fax
(770) 953-4640
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 002323 GA Primary

Addresses

Primary practice location

1827 Powers Ferry Rd SE
BLDG 22 Ste 200
Atlanta, GA 30339-5621

Mailing address

1827 Powers Ferry Rd SE
BLDG 22 Ste 200
Atlanta, GA 30339-5621
Phone (770) 953-4744

Other identifiers 1

IdentifierTypeStateIssuer
00842421BMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040513000272 GA Practitioner - Clinical Psychologist 8527058551 Practice locations: Atlanta, GA; Canton, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1827 Powers Ferry Serd
Suite 22
Atlanta, GA 30339-5621
Phone (770) 953-4744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
002323GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Compass Psychiatry LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184794778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 POWERS FERRY RD SE",
            "address_2": "BLDG 22 STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395621",
            "telephone_number": "770-953-4744",
            "fax_number": "770-953-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 POWERS FERRY RD SE",
            "address_2": "BLDG 22 STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395621",
            "telephone_number": "770-953-4744",
            "fax_number": "770-953-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASSA",
        "first_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "002323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00842421B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.