Newnan Psychological Services

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1788 Issued in GA

Legal business name

NEWNAN PSYCHOLOGICAL SERVICES

Practice address

45B Sutherland Dr
Newnan, GA 30263-1455

Phone

(770) 683-3512

Fax

(770) 683-3513

NPI assigned

May 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Tony Alan Johnson, PH.D.NPI 1699890418

Title

Ceo/Psychologist

Phone

(770) 683-3512

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Tony Alan Johnson, PH.D.

  • Psychologist
  • Newnan, GA
  • NPI 1699890418
  NPD (past) Authorized official

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1235306663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45B SUTHERLAND DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631455",
            "telephone_number": "770-683-3512",
            "fax_number": "770-683-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45B SUTHERLAND DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631455",
            "telephone_number": "770-683-3512",
            "fax_number": "770-683-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWNAN PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CEO/PSYCHOLOGIST",
        "authorized_official_telephone_number": "770-683-3512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "1788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000609089C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.