Jennifer Ann Crumbley-Dodson, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY002623 Issued in GA

Practice address

8304 Office Park Dr
Douglasville, GA 30134-6935

Phone

(678) 838-9336

Fax

(678) 838-3619

NPI assigned

Apr 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1669696282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 MAXWELL ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304209",
            "telephone_number": "404-271-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8304 OFFICE PARK DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346935",
            "telephone_number": "678-838-9336",
            "fax_number": "678-838-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMBLEY-DODSON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.