Charles Daniel Allen III, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

1640 Powers Ferry Rd SE
Building 27, Suite 150
Marietta, GA 30067-5491

Phone

(770) 428-8686

NPI assigned

Oct 24, 2013

Last updated

Oct 24, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Aspire Wellness of East Cobb LLC

  • Mental Health Counselor
  • Marietta, GA
  • NPI 1932031630
  NPD Authorized official

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1508294869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "address_2": "BUILDING 27, SUITE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-428-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD SE",
            "address_2": "BUILDING 27, SUITE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-428-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "CHARLES",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Counseling Clinic LLC (Allen Counseling Clinic)
• Allen Lazerson (A Family Podiatry Center)
• Allen Surgical LLC
• Ashli Dian Allen
• Brennan Allen, APC, MA, NCC
• Chloe Winn Allen
• Christian Frederick Allen, P.A.
• Craig James Allen, DC
• Latifah Ashley Allen, RBT
• Sarah Allen

• Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.