Cameron Grace Hom

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY004217 Issued in GA

Practice address

3760 Lavista Rd Ste 102
Tucker, GA 30084-5622

Phone

(770) 375-8124

NPI assigned

May 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1716595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716595200000",
    "number": "1225878507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 MOCKINGBIRD LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301160",
            "telephone_number": "919-451-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 LAVISTA RD STE 102",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845622",
            "telephone_number": "770-375-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOM",
        "first_name": "CAMERON",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-25",
        "last_updated": "2024-05-25",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenton Donelle Hodge, LDO
• Margaret H Hodges, PH.D.
• Elaine Carol Hoffman-Fowler
• Maryellen Hogan, CCC-SLP
• Deneisha Hollis
• Ronald A Homer, MD
• Danielle Ann Honda
• Jennifer Joyce Honein
• Lynn Honeycutt, LAPC
• Jolanta Wazgowska Hopkins, LCSW

• Psychologist in Tucker, GA
• Providers in Tucker, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2024; 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.