Sweetwater Psychological Associates, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY001373,PSY001157 Issued in GA

Legal business name

SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC

Practice address

560 Thornton Rd
Suite 106
Lithia Springs, GA 30122-1655

Phone

(770) 732-0982

Fax

(770) 732-1283

NPI assigned

Aug 30, 2006

Last updated

Oct 27, 2007By 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

David C Martin, PH.D

Title

Owner Partner

Phone

(770) 732-0982

Specialties & licenses 6

Addresses

Locations

Practitioners 4

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.

• Kenia Johnson Lewis, PH.D.

  • Clinical Psychologist
  • Lithia Springs, GA
  • NPI 1801028352
  NPD (past)
• Patricia Antonia Johnson, MSSW

  • Mental Health Counselor
  • Marietta, GA
  • NPI 1972527000
  NPD (past)
• Nancy Ellen Reigle, PH.D,

  • Clinical Psychologist
  • Marietta, GA
  • NPI 1699859876
  NPD (past)
• David M Saltzman, PH.D.

  • Clinical Psychologist
  • Lithia Springs, GA
  • NPI 1902973928
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193443200000",
    "number": "1467562827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1078",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301227078",
            "telephone_number": "770-732-0982",
            "fax_number": "770-732-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 THORNTON RD",
            "address_2": "SUITE 106",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301221655",
            "telephone_number": "770-732-0982",
            "fax_number": "770-732-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-10-27",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER PARTNER",
        "authorized_official_telephone_number": "770-732-0982",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001373, PSY001157",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "PSY001373",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "PSY001157",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY001373,PSY001157",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY001373, PSY001157",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW000729",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khanetha Stokes
• Joshua Jerome Stuger, DPT
• Surgichoice Surgical, LLC
• Ryan L Sutton, LCSW
• Sweet Water Family Dentistry
• Sweetwater Springs
• Tailored Occupational Therapy LLC
• Praise Tarver, BCBA
• Taylor Healing Institute
• Tekay Enterprise

• Clinical Psychologist in Lithia Springs, GA
• Providers in Lithia Springs, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; 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.