Justin Donaldson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

003538 Issued in GA

Practice address

315 W Ponce de Leon Ave
Suite 1064
Decatur, GA 30030-2400

Phone

(404) 654-3411

NPI assigned

Feb 2, 2012

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1376815563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE",
            "address_2": "SUITE 1064",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302400",
            "telephone_number": "404-654-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE",
            "address_2": "SUITE 1064",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302400",
            "telephone_number": "404-654-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "003538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather C. Domingue, PHD
• Mirnouve Domond, DO
• Donald C Siegel MD PC
• Donald C, Siegel, M.D., F.a.C.S.
• Candace Donaldson-Scott
• Patricia Colquhoun Donaldson I, RN
• Theresa Dondzila, OTR/L
• Christopher Dooley, MD
• Ladi Doonquah, MD
• Dope Healing

• Clinical Psychologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.