Active NPI
Maria Averbukh
- Psychologist
- Roswell, GA
National Provider Identifier
1295480408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 12090 Wexford Overlook
Roswell, GA 30075-1454 - Phone
- (215) 512-1231
- NPI assigned
- Feb 16, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
12090 Wexford Overlook
Roswell, GA 30075-1454
Mailing address
12090 Wexford Overlook
Roswell, GA 30075-1454
Phone (215) 512-1231
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644969600000",
"number": "1295480408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12090 WEXFORD OVERLOOK",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300751454",
"telephone_number": "215-512-1231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12090 WEXFORD OVERLOOK",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300751454",
"telephone_number": "215-512-1231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERBUKH",
"first_name": "MARIA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-16",
"last_updated": "2022-02-16",
"certification_date": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.