Individual provider Active NPI

Sabrina Hickle, PH.D.

  • Clinical Psychologist
  • Smyrna, GA
National Provider Identifier
1205500535
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY004470 Issued in GA
Practice address
2400 Lake Park Dr SE Ste 110
Smyrna, GA 30080-8979
Phone
(770) 933-4130
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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 PSY004470 GA Primary

Addresses

Primary practice location

2400 Lake Park Dr SE Ste 110
Smyrna, GA 30080-8979

Mailing address

4047 Elm St
Chamblee, GA 30341-1670

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
I20211006002579 GA Practitioner - Clinical Psychologist 5890193767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jason a King PHD LLCGroup PAC ID 1153338850, 3 clinicians

Practice addresses (Care Compare)

2400 Lake Park Dr SE
Suite 110
Smyrna, GA 30080-8979
Phone (678) 641-6204

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Oct 1, 2021 Accepting new patients
Jason a. King, PH.D., LLC Clinical Neuropsychologist CurrentSince Apr 29, 2024 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

2400 Lake Park Dr SE
Ste 110
Smyrna, GA 30080
Phone (678) 641-6204

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1205500535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 ELM ST",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303411670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LAKE PARK DR SE STE 110",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808979",
            "telephone_number": "770-933-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLE",
        "first_name": "SABRINA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.