North Georgia Neuropsychological Services

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY002863 Issued in GA

Legal business name

NORTH GEORGIA NEUROPSYCHOLOGICAL SERVICES

Practice address

1485 Jesse Jewel Parkway SE
Gainesville, GA 30501

Phone

(678) 462-0762

NPI assigned

Mar 15, 2017

Last updated

Mar 15, 2017By 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

Dr. Justin Huthwaite, PSY.D.

Title

President

Phone

(678) 462-0762

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1407397037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7145 LANIER COVE COURT",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300412198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 JESSE JEWEL PARKWAY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "678-462-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GEORGIA NEUROPSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "HUTHWAITE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-462-0762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "PSY002863",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002863",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.