Psych Centers of Georgia LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PSYCH CENTERS OF GEORGIA LLC

Practice address

368 W Pike St Ste 105a
Lawrenceville, GA 30046-3240

Phone

(678) 203-8802

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Gairy Johnson

Title

Board Advisor

Phone

(678) 538-9314

Specialties & licenses 2

Addresses

Other names 1

• Neuropsych Centers Doing business as

Locations

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1336730936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 W PIKE ST STE 105A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 W PIKE ST STE 105A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463240",
            "telephone_number": "678-203-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH CENTERS OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2023-12-13",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GAIRY",
        "authorized_official_title_or_position": "BOARD ADVISOR",
        "authorized_official_telephone_number": "678-538-9314"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuropsych Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neuropsych Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Proliance LLC
• Prosperity Home Care, LLC
• Angel Provost, RN
• Tonya Michelle Pruitt, PTA
• Julie Pryor, NP
• Psychiatric Services of America
• Publix Super Markets Inc
• Publix Super Markets Inc
• Publix Super Markets Inc
• Publix Super Markets Inc

• Psychologist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.