Family and Child Development Center of Johns Creek LTD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2289 Issued in GA

Legal business name

FAMILY AND CHILD DEVELOPMENT CENTER OF JOHNS CREEK LTD

Practice address

360 Prospect PL
Alpharetta, GA 30005-5467

Phone

(404) 433-7363

Fax

(770) 645-9281

NPI assigned

Oct 16, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Lucinda Taylor Grapenthin

Title

Owner

Phone

(404) 433-7363

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1639422603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ARGYLL CRST",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226118",
            "telephone_number": "404-433-7363",
            "fax_number": "770-645-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 PROSPECT PL",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300055467",
            "telephone_number": "404-433-7363",
            "fax_number": "770-645-9281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND CHILD DEVELOPMENT CENTER OF JOHNS CREEK LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "GRAPENTHIN",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-433-7363",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "2289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000922556A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.