Traci Anne Paulk

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

778131 Issued in GA

Practice address

996 Coley Station Rd
Cochran, GA 31014-5548

Phone

(478) 230-4348

NPI assigned

Dec 4, 2024

Last updated

Dec 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1609682772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 COLEY STATION RD",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310145548",
            "telephone_number": "478-230-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "996 COLEY STATION RD",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310145548",
            "telephone_number": "478-230-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK",
        "first_name": "TRACI",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TN",
            "license": "778131",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "GA",
            "license": "778131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Psychologist in Cochran, GA
• Providers in Cochran, GA by specialty
• School Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.