Buddington Psychology Clinic, PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY001926 Issued in GA

Legal business name

BUDDINGTON PSYCHOLOGY CLINIC, PC

Practice address

4485 Tench Rd
Suite 840
Suwanee, GA 30024-6741

Phone

(770) 493-9177

Fax

(770) 945-7214

NPI assigned

Dec 19, 2007

Organization subpart

No

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

Authorized official

Name

Roger W. Buddington, PH.D.NPI 1639353246

Title

President

Phone

(770) 493-9177

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roger W Buddington, PH.D.

  • Psychologist
  • Suwanee, GA
  • NPI 1639353246
  NPD (past) Authorized official
• Sharon C Buddington, LCSW

  • Clinical Social Worker
  • Suwanee, GA
  • NPI 1457535064
  NPD (past)

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1366626970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 TENCH RD",
            "address_2": "SUITE 840",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246741",
            "telephone_number": "770-493-9177",
            "fax_number": "770-945-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 TENCH RD",
            "address_2": "SUITE 840",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246741",
            "telephone_number": "770-493-9177",
            "fax_number": "770-945-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUDDINGTON PSYCHOLOGY CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "BUDDINGTON",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-493-9177",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001926",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrice Nicole Brown, PT, DPT
• Summer Brown, RN
• Emalyn Brumby, OTR/L
• Kathleen Brunner, M.ED.CCC-SLP
• Rita Mong Bruss, LMT
• Roger W Buddington, PH.D.
• Sharon C Buddington, LCSW
• Marla Kiser Buie, AGPCNP
• Building Bolcks 4 Life
• Building Intimate Marriages, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.