NPIMap

Organization Active NPI

Southern Psychiatric Professionals, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Senoia, GA
National Provider Identifier
1295246635
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOUTHERN PSYCHIATRIC PROFESSIONALS, LLC
Practice address
48 Main St Ste 2a
Senoia, GA 30276-1895
Phone
(770) 400-9660
NPI assigned
Oct 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Authorized official

Name
Dr. Shane SavageNPI 1891960548
Title
President/Coo
Phone
(770) 400-9660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

48 Main St Ste 2a
Senoia, GA 30276-1895

Mailing address

48 Main St Ste 2a
Senoia, GA 30276-1895
Phone (770) 400-9660

National Provider Directory

National Provider Directory

Locations

48 Main St
Ste 2A
Senoia, GA 30276
Phone (770) 400-9660

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1295246635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MAIN ST STE 2A",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302761895",
            "telephone_number": "770-400-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MAIN ST STE 2A",
            "city": "SENOIA",
            "state": "GA",
            "postal_code": "302761895",
            "telephone_number": "770-400-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PSYCHIATRIC PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "SAVAGE",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "770-400-9660",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Senoia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.