Individual provider Active NPI

Avital Karmel Cohen

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1184870453
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY003672 Issued in GA
Practice address
750 Hammond Dr NE
Building 7, Suite 200
Atlanta, GA 30328-5532
Phone
(678) 999-3477
Fax
(678) 999-3567
NPI assigned
Aug 18, 2008
Last updated
Jul 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1580 AL
Clinical Psychologist 103TC0700X PSY003672 GA Primary

Addresses

Primary practice location

750 Hammond Dr NE
Building 7, Suite 200
Atlanta, GA 30328-5532

Mailing address

750 Hammond Dr NE
Building 7, Suite 200
Atlanta, GA 30328-5532
Phone (678) 999-3477

Other identifiers 1

IdentifierTypeStateIssuer
003133917AMedicaidGA

Other names 1

  • Dr. Avital Karmel Herbin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY003672GAMDClinical Psychologist
1580ALMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Pediatric Psychology, LLC Current Accepting new patients

Locations

750 Hammond Dr
Bldg 10
Sandy Springs, GA 30328
Phone (404) 245-7981

750 Hammond Dr
Bldg 7
Sandy Springs, GA 30328
Phone (404) 796-7777

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1184870453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 HAMMOND DR NE",
            "address_2": "BUILDING 7, SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285532",
            "telephone_number": "678-999-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HAMMOND DR NE",
            "address_2": "BUILDING 7, SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285532",
            "telephone_number": "678-999-3477",
            "fax_number": "678-999-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "AVITAL",
        "middle_name": "KARMEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1580",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003133917A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVITAL",
            "last_name": "HERBIN",
            "middle_name": "KARMEL",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.