NPIMap

Organization Active NPI

Georgia Psychological Treatment Center LLC

  • Mental Health Counselor
  • Marietta, GA
National Provider Identifier
1427569185
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GEORGIA PSYCHOLOGICAL TREATMENT CENTER LLC
Practice address
1640 Powers Ferry Rd SE
Marietta, GA 30067-5491
Phone
(770) 575-1696
Fax
(404) 891-6467
NPI assigned
Oct 20, 2017
Last updated
Oct 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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

Authorized official

Name
Dr. Lydia Odenat, PHDNPI 1366847097
Title
Psychologist
Phone
(678) 687-9149

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1640 Powers Ferry Rd SE
Marietta, GA 30067-5491

Mailing address

1777 Walker Ridge Dr SW
Marietta, GA 30064-4192
Phone (678) 687-9149

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508457600000",
    "number": "1427569185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 WALKER RIDGE DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644192",
            "telephone_number": "678-687-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-575-1696",
            "fax_number": "404-891-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PSYCHOLOGICAL TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A",
        "authorized_official_last_name": "ODENAT",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "678-687-9149",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.