Active NPI
Douglas Jay Stone-Miller, PH.D.
- Clinical Psychologist
- Atlanta, GA
National Provider Identifier
1629369699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY002081
- Practice address
- 829 Dixie Ave.
Atlanta, GA 30307 - Phone
- (770) 957-7777
- Fax
- (404) 658-9505
- NPI assigned
- Apr 26, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY002081 | GA | Primary |
Addresses
Primary practice location
829 Dixie Ave.
Atlanta, GA 30307
Mailing address
3939 Jodeco Rd
McDonough, GA 30253-5477
Phone (770) 957-7777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY002081 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303776000000",
"number": "1629369699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3939 JODECO RD",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302535477",
"telephone_number": "770-957-7777",
"fax_number": "770-957-0957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "829 DIXIE AVE.",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30307",
"telephone_number": "770-957-7777",
"fax_number": "404-658-9505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STONE-MILLER",
"first_name": "DOUGLAS",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-26",
"last_updated": "2011-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY002081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.