NPIMap

Organization Active NPI

Trinity Psychological Services

  • Counseling Psychologist
  • Johns Creek, GA
National Provider Identifier
1548411101
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY0002798 Issued in GA
Legal business name
TRINITY PSYCHOLOGICAL SERVICES
Practice address
9635 Ventana Way
Suite 101
Johns Creek, GA 30022-8261
Phone
(678) 366-8862
Fax
(678) 739-0119
NPI assigned
Oct 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Authorized official

Name
Dr. Robert Montes, PHD
Title
Owner/Operator
Phone
(678) 366-8862

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 002798 GA
Addiction (Substance Use Disorder) PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TA0400X PSY0002798 GA
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PSY0002798 GA
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X PSY0002798 GA Primary
Family PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TF0000X PSY0002798 GA

Addresses

Primary practice location

9635 Ventana Way
Suite 101
Johns Creek, GA 30022-8261

Mailing address

9635 Ventana Way
Suite 101
Johns Creek, GA 30022-8261
Phone (678) 366-8862

National Provider Directory

National Provider Directory

Locations

9635 Ventana Way
Ste 101
Johns Creek, GA 30022
Phone (678) 366-8862

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1548411101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9635 VENTANA WAY",
            "address_2": "SUITE 101",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228261",
            "telephone_number": "678-366-8862",
            "fax_number": "678-739-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 VENTANA WAY",
            "address_2": "SUITE 101",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228261",
            "telephone_number": "678-366-8862",
            "fax_number": "678-739-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "MONTES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "678-366-8862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "002798",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "PSY0002798",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY0002798",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "GA",
            "license": "PSY0002798",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "GA",
            "license": "PSY0002798",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.