The Family Center of Georgia, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002858 Issued in GA

Legal business name

THE FAMILY CENTER OF GEORGIA, INC.

Practice address

2520 Hollingsworth St
Lithonia, GA 30058-4424

Phone

(770) 484-8834

NPI assigned

Sep 1, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Halisi Edwards Staten, PSYD

Title

Licensed Psychologist

Phone

(678) 768-1214

Specialties & licenses 4

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Halisi Jacqueline Edwards, PSY.D.

  • Mental Health Counselor
  • Decatur, GA
  • NPI 1881610673
  NPD (past)
• William Schneider, M.D.

  • Forensic Psychiatry Physician
  • Villa Rica, GA
  • NPI 1023273109
  NPD (past)
• Harriette Denice Green, MD

  • Child & Adolescent Psychiatry Physician
  • Porterville, CA
  • NPI 1700812765
  NPD (past)

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251763200000",
    "number": "1669605127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6964 HARBOR TOWN WAY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300875467",
            "telephone_number": "770-484-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 HOLLINGSWORTH ST",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584424",
            "telephone_number": "770-484-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY CENTER OF GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-01",
        "last_updated": "2009-09-01",
        "status": "A",
        "authorized_official_last_name": "STATEN",
        "authorized_official_first_name": "HALISI",
        "authorized_official_middle_name": "EDWARDS",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "678-768-1214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "C0067",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002858",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "GA",
            "license": "PSY002858",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "GA",
            "license": "PSY002858",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86355324D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; 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.