Lydia Odenat, PHD

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

PSY003854 Issued in GA

Practice address

1640 Powers Ferry Rd SE BLDG 18-250
Marietta, GA 30067-9461

Phone

(678) 687-9149

NPI assigned

Oct 23, 2014

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 2, 2024 through Jan 2, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Psychological Treatment Center LLC

  • Mental Health Counselor
  • Marietta, GA
  • NPI 1427569185
  NPD Authorized official
• Carrefour of Atlanta Psychological Health Institute LLC

  • Psychologist
  • Atlanta, GA
  • NPI 1457741829
  Authorized official Same address or phone

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366847097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 WALKER RIDGE DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644192",
            "telephone_number": "678-687-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE BLDG 18-250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300679461",
            "telephone_number": "678-687-9149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2751 Buford Hwy NE Ste 700",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303245510",
            "country_code": "US",
            "telephone_number": "678-687-9149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODENAT",
        "first_name": "LYDIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "PSY003854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chinazaekpere Darlene Ochiobi, RPH
• Izel Magdalena Ochoa
• Ocmulgee Medical Pathology Association Inc
• Amanda Odegaard, OTR/L
• Sharon M Odell, MD
• Beatrice Odero
• Christina Anna Nicole Odom, FNP
• Barbara Ellen Ohlman Oess, WHNP-BC
• Onaopemipo Olayide Ofodile, M.D.
• Ashmeer Ogbuchi, MD

• Cognitive & Behavioral Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Cognitive & Behavioral Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.