Mark D Ackerman, PHD

Individual provider Active NPI Clinical Psychologist · Atlanta, GA

NPI 1376651653 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376651653
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
1647 (GA)
Practice address
3280 Howell Mill Rd NW
217 E
Atlanta, GA 30327-4111
Phone
(404) 428-1887
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1647GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven L Morganstern Urology Clinic Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1647 GA Yes

Addresses

Primary practice location

3280 Howell Mill Rd NW
217 E
Atlanta, GA 30327-4111

Mailing address

PO Box 888213
Atlanta, GA 30356-0213
Phone (404) 428-1887

Other providers in Atlanta, GA

All providers in Atlanta, GA · Clinical Psychologist in Georgia

Sources for this page

Verify at the official NPI Registry.