Individual provider Active NPI

George O Karasievich, PSY D

  • Psychologist
  • Dalton, GA
National Provider Identifier
1417938366
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 00637 Issued in GA
Practice address
475 Reed Rd Ste 104
Dalton, GA 30720-6307
Phone
(706) 529-8710
Fax
(706) 529-8715
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 00637 GA Primary

Addresses

Primary practice location

475 Reed Rd Ste 104
Dalton, GA 30720-6307

Mailing address

475 Reed Rd Ste 104
Dalton, GA 30720-6307
Phone (706) 529-8710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040624000199 TN Practitioner - Clinical Psychologist 0749265502 Reassigns benefits to 1 organization
I20191221000320 GA Practitioner - Clinical Psychologist 0749265502

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Baylor College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Beginnings Counseling Center PLLCGroup PAC ID 4688659196, 4 clinicians

Practice addresses (Care Compare)

2120 Northgate Park LN
Suite 201
Chattanooga, TN 37415-6952
Phone (423) 870-5647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 00637GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Beginnings Counseling Center PLLC CurrentSince Nov 8, 1999 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Reliant Healthcare LLC Past Accepting new patients

Locations

1406 Broadrick Dr
Dalton, GA 30720
Phone (706) 272-6480

475 Reed Rd
Ste 104
Dalton, GA 30720
Phone (706) 278-1622

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

2120 Northgate Park Ln
Ste 201
Chattanooga, TN 37415
Phone (423) 870-5647

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1417938366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 REED RD STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307206307",
            "telephone_number": "706-529-8710",
            "fax_number": "706-529-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 REED RD STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307206307",
            "telephone_number": "706-529-8710",
            "fax_number": "706-529-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARASIEVICH",
        "first_name": "GEORGE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY 00637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.