NPIMap

Organization Active NPI

Elaine a Thomas PSYD LLC

  • Clinical Child & Adolescent Psychologist
  • Marietta, GA
National Provider Identifier
1447584578
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY#2936 Issued in GA
Legal business name
ELAINE A THOMAS PSYD LLC
Practice address
316 Alexander St SE
Suite 6
Marietta, GA 30060-8217
Phone
(770) 216-0460
Fax
(678) 581-0146
NPI assigned
Sep 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Dr. Elaine Angela Thomas, PSY.D.NPI 1881869972
Title
Licensed Psychologist/Owner
Phone
(770) 216-0460

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X PSY#2936 GA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY#2936 GA
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X PSY#2936 GA Primary

Addresses

Primary practice location

316 Alexander St SE
Suite 6
Marietta, GA 30060-8217

Mailing address

316 Alexander St SE
Suite 6
Marietta, GA 30060-8217
Phone (770) 216-0460

Other identifiers 1

IdentifierTypeStateIssuer
583311126AMedicaidGA

National Provider Directory

National Provider Directory

Locations

316 Alexander St SE
Ste 6
Marietta, GA 30060
Phone (770) 216-0460

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1447584578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 ALEXANDER ST SE",
            "address_2": "SUITE 6",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608217",
            "telephone_number": "770-216-0460",
            "fax_number": "678-581-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 ALEXANDER ST SE",
            "address_2": "SUITE 6",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608217",
            "telephone_number": "770-216-0460",
            "fax_number": "678-581-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELAINE A THOMAS PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "ANGELA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "770-216-0460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "PSY#2936",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY#2936",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY#2936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "583311126A",
            "state": "GA"
        }
    ],
    "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 Mar 17, 2010; 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.