Individual provider Active NPI

Kathryn Bryan, PHD

  • Counseling Psychologist
  • Atlanta, GA
National Provider Identifier
1679052351
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY004313 Issued in GA
Practice address
814 Juniper St NE Ste 201
Atlanta, GA 30308-1300
Phone
(404) 965-5843
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY004313 GA Primary

Addresses

Primary practice location

814 Juniper St NE Ste 201
Atlanta, GA 30308-1300

Mailing address

760 Dalerose Ave
Decatur, GA 30030-3936

Other practice location 1

760 Dalerose Ave
Decatur, GA 30030-3936
Phone (404) 965-5843

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY004313GAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Resources LLC Counseling Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1679052351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 DALEROSE AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 JUNIPER ST NE STE 201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081300",
            "telephone_number": "404-965-5843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Dalerose Ave",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300303936",
            "country_code": "US",
            "telephone_number": "404-965-5843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "KATHRYN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "GA",
            "license": "PSY004313",
            "primary": true
        }
    ],
    "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 Sep 9, 2019; 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.