Diane C. Sperry

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003160 Issued in GA

Practice address

10475 Medlock Bridge Rd
Building 300; Suite 315
Johns Creek, GA 30097-4433

Phone

(678) 935-9567

Fax

(678) 935-9568

NPI assigned

Apr 24, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Diane C. Sperry Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1649445206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10475 MEDLOCK BRIDGE RD",
            "address_2": "BUILDING 300; SUITE 315",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300974433",
            "telephone_number": "678-935-9567",
            "fax_number": "678-935-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 MEDLOCK BRIDGE RD",
            "address_2": "BUILDING 300; SUITE 315",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300974433",
            "telephone_number": "678-935-9567",
            "fax_number": "678-935-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERRY",
        "first_name": "DIANE",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003160",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AL",
            "license": "652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "SPERRY",
            "middle_name": "C.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Southern Sky Outpatient Detox, LLC
• Nicole A Sparks, M.D.
• Special Transition Works , LLC
• Jay Erin Spector, DPM
• Speech Therapy Telepractice, LLC
• Diane L Spiva, CRNP
• St Mikels Behavioral Health Services LLC
• Monique Jennifer Stage, FNP-BC
• Courtney Eileen Starnes
• Stat Medical Care Inc

• Clinical Psychologist in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.