Individual provider Active NPI

Sheila Rauch, PH.D.

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1326139858
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY003903 Issued in GA
Practice address
12 Executive Park Dr NE FL 3
Atlanta, GA 30329-2206
Phone
(404) 778-1428
NPI assigned
Sep 28, 2006
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301012991 MI
Clinical Psychologist 103TC0700X PSY003903 GA Primary

Addresses

Primary practice location

12 Executive Park Dr NE FL 3
Atlanta, GA 30329-2206

Mailing address

12 Executive Park Dr NE FL 3
Atlanta, GA 30329-2206
Phone (404) 778-1428

Other practice location 1

1670 Clairmont Rd
Decatur, GA 30033-4004
Phone (404) 321-6111 ext. 20312

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY003903GAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1326139858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DR NE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292206",
            "telephone_number": "404-778-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DR NE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292206",
            "telephone_number": "404-778-1428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Clairmont Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300334004",
            "country_code": "US",
            "telephone_number": "404-321-6111 x20312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAUCH",
        "first_name": "SHEILA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012991",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.