Individual provider Active NPI

Nancy Jane Gup, PSY.D

  • Psychologist
  • Atlanta, GA
National Provider Identifier
1376573543
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
GA002414 Issued in GA
Practice address
2885 Payton Rd NE
Atlanta, GA 30345-2600
Phone
(404) 634-0014
Fax
(404) 728-0043
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2414 GA
Clinical Psychologist 103TC0700X GA002414 GA
Adult Development & Aging Psychologist 103TA0700X GA002414 GA
Cognitive & Behavioral Psychologist 103TB0200X GA002414 GA
Family Psychologist 103TF0000X GA002414 GA
Psychologist 103T00000X GA002414 GA Primary

Addresses

Primary practice location

2885 Payton Rd NE
Atlanta, GA 30345-2600

Mailing address

2885 Payton Rd NE
Atlanta, GA 30345-2600
Phone (404) 634-0014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2414GAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376573543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 PAYTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452600",
            "telephone_number": "404-634-0014",
            "fax_number": "404-728-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885 PAYTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452600",
            "telephone_number": "404-634-0014",
            "fax_number": "404-728-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUP",
        "first_name": "NANCY",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "2414",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "GA002414",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "GA",
            "license": "GA002414",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "GA002414",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "GA",
            "license": "GA002414",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "GA002414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.