Priscilla B Faulkner, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY002144 Issued in GA

Practice address

3155 Mill Street
Covington, GA 30014-2542

Phone

(678) 712-6520

Fax

(678) 712-6521

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southeastern Psychological Associates IncGroup PAC ID 9537320254, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeastern Psychological Associates, Inc

  • Clinical Child & Adolescent Psychologist
  • Covington, GA
  • NPI 1316216880
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1366579773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 MILL STREET",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142542",
            "telephone_number": "678-712-6520",
            "fax_number": "678-712-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 MILL STREET",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142542",
            "telephone_number": "678-712-6520",
            "fax_number": "678-712-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "PRISCILLA",
        "middle_name": "B",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000765751A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kourosh Farahvashi, OD
• Vincent Bernard Farrell, FNP-C
• Meridith Farrow, M.D.
• Tyhisha Paden Fashipe, OT
• Lucinda Chappel Faulkner, ARNP
• Robert Lee Faulkner Jr., MD
• Faull S. Trover, M.D.,P.C.
• Bianca Felix
• Ansley Head Ferguson, PT, DPT
• Keisha Damorley Ferguson, FNP-BC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.