Individual provider Active NPI

Lynn Mary Karjala, PH.D.

  • Clinical Psychologist
  • Roswell, GA
National Provider Identifier
1477698546
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY001128 Issued in GA
Practice address
11195 Hembree Springs Dr
Roswell, GA 30076-1233
Phone
(770) 754-0751
NPI assigned
Feb 20, 2007
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY001128 GA Primary

Addresses

Primary practice location

11195 Hembree Springs Dr
Roswell, GA 30076-1233

Mailing address

PO Box 1150
Roswell, GA 30077-1150
Phone (770) 754-0751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051202000153 GA Practitioner - Clinical Psychologist 0143240317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Roswell, GA 30076
Phone (770) 754-0751

11195 Hembree Springs Dr
Roswell, GA 30076-1233

PO Box
Suite 1150
Roswell, GA 30077-1150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY001128GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Innovations, P.C. Clinical CurrentSince Mar 5, 2010 Accepting new patients

Locations

11205 Alpharetta Hwy
Ste A4
Roswell, GA 30076
Phone (770) 754-0751

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1477698546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300771150",
            "telephone_number": "770-754-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11195 HEMBREE SPRINGS DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761233",
            "telephone_number": "770-754-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARJALA",
        "first_name": "LYNN MARY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY001128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.