Organization Active NPI

Joni E Prince PHD PC

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1639286198
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1723 Issued in GA
Legal business name
JONI E PRINCE PHD PC
Practice address
6065 Roswell Rd Ste 515
Atlanta, GA 30328-4015
Phone
(404) 461-9067
Fax
(404) 461-9067
NPI assigned
Aug 23, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Dr. Joni E Prince, PHDNPI 1750496675
Title
Clinical Psychologist
Phone
(404) 461-9067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 1723 GA Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

6065 Roswell Rd Ste 515
Atlanta, GA 30328-4015

Mailing address

1185 Hightower TRL Unit 500356
Atlanta, GA 31150-3106
Phone (404) 735-4935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130313000353 GA Part B Supplier - Clinic/Group Practice 1254586530 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

1185 Hightower Trl
Unit 500356
Atlanta, GA 31150

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1639286198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 HIGHTOWER TRL UNIT 500356",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311503106",
            "telephone_number": "404-735-4935",
            "fax_number": "404-735-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6065 ROSWELL RD STE 515",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284015",
            "telephone_number": "404-461-9067",
            "fax_number": "404-461-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONI E PRINCE PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "JONI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "404-461-9067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1723",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.