Metro Atlanta Psychological Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY002865 Issued in GA

Legal business name

METRO ATLANTA PSYCHOLOGICAL SERVICES, LLC

Practice address

5825 Glenridge Dr NE
BLDG. 2, St.E. 120
Atlanta, GA 30328-5387

Phone

(404) 303-1935

Fax

(404) 303-8488

NPI assigned

Jun 9, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy Wasserman Loeb, M.S., L.P.C.

Title

Co-President

Phone

(770) 417-2732

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1306072954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 GLENRIDGE DR NE",
            "address_2": "BLDG. 2, ST.E. 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285387",
            "telephone_number": "404-303-1935",
            "fax_number": "404-303-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 GLENRIDGE DR NE",
            "address_2": "BLDG. 2, ST.E. 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285387",
            "telephone_number": "404-303-1935",
            "fax_number": "404-303-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO ATLANTA PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-09",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "LOEB",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "WASSERMAN",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "770-417-2732",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S., L.P.C."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC001688",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003775",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC002966",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002865",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.