Organization Active NPI

Khan Interstellar Psychology and Consulting

  • Clinical Psychologist
  • Berkeley Lake, GA
National Provider Identifier
1316804750
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
KHAN INTERSTELLAR PSYCHOLOGY AND CONSULTING
Practice address
3301 N Berkeley Lake Rd NW FL 1
Berkeley Lake, GA 30096-3187
Phone
(770) 331-4882
NPI assigned
Jan 7, 2026
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Dr. Humama Khan, PHDNPI 1467169375
Title
Ceo
Phone
(843) 566-5841

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
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

3301 N Berkeley Lake Rd NW FL 1
Berkeley Lake, GA 30096-3187

Mailing address

202 Misty Grove Dr
Loganville, GA 30052-9054
Phone (843) 566-5841

National Provider Directory

National Provider Directory

Locations

3301 N Berkeley Lake Rd NW
Fl 1
Berkeley Lake, GA 30096
Phone (470) 657-2991

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1316804750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 MISTY GROVE DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300529054",
            "telephone_number": "843-566-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N BERKELEY LAKE RD NW FL 1",
            "city": "BERKELEY LAKE",
            "state": "GA",
            "postal_code": "300963187",
            "telephone_number": "770-331-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHAN INTERSTELLAR PSYCHOLOGY AND CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "HUMAMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-566-5841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Lake, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.