Eversley Devon Pemberton, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003607 Issued in GA

Practice address

340 Boulevard NE
345
Atlanta, GA 30312-1273

Phone

(404) 653-0322

Fax

(404) 653-0466

NPI assigned

Aug 28, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1528316163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 RIVERROCK TRL",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961169",
            "telephone_number": "404-808-8207",
            "fax_number": "678-519-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOULEVARD NE",
            "address_2": "345",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121273",
            "telephone_number": "404-653-0322",
            "fax_number": "404-653-0466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Cleveland Ave SW Ste 604",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303157116",
            "country_code": "US",
            "telephone_number": "470-352-6556",
            "fax_number": "404-549-9650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "EVERSLEY",
        "middle_name": "DEVON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-28",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003127613A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Pelling
• Richard Antonio Pellizzari II, MD
• Dawn Pelow
• Arie E Pelta, M.D.
• Bernadette A Peltier, MD
• Judy S. Pemberton, PH.D.
• William Pemu
• Jorge Isaac Pena Garcia, M.D.
• Marioly Pena-Donady
• Gyliann M Pena

• Clinical Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.