Peach and Palm Women's Health Psychology, PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PEACH AND PALM WOMEN'S HEALTH PSYCHOLOGY, PC

Practice address

540 Valley Hall Dr
Atlanta, GA 30350-4631

Phone

(770) 809-6995

NPI assigned

Jul 1, 2024

Last updated

Oct 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lily Victoria Kadosh, PSYDNPI 1902311756

Title

Ceo

Phone

(770) 809-6995

Specialties & licenses 1

Addresses

Other names 1

• previous corp was Peach and Palm Women's Health Counseling w diff ein Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lily Victoria Kadosh, PSYD

  • Psychologist
  • Atlanta, GA
  • NPI 1902311756
  NPD Authorized official

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1376389213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 DUNWOODY CLUB DR STE 106-196",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303505434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 VALLEY HALL DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303504631",
            "telephone_number": "770-809-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH AND PALM WOMEN'S HEALTH PSYCHOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "KADOSH",
        "authorized_official_first_name": "LILY",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-809-6995",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "previous corp was Peach and Palm Women's Health Counseling w diff ein",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.