Michael Bucovetsky, Psy.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003351 Issued in GA

Legal business name

MICHAEL BUCOVETSKY, PSY.D., P.C.

Practice address

2308 Perimeter Park Dr Ste 100
Atlanta, GA 30341-1316

Phone

(770) 457-5577

Fax

(770) 457-5599

NPI assigned

Jul 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Michael Bucovetsky, PSY.D.

Title

Psychologist

Phone

(770) 457-5577

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1679885941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 PERIMETER PARK DR STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411316",
            "telephone_number": "770-457-5577",
            "fax_number": "770-457-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 PERIMETER PARK DR STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411316",
            "telephone_number": "770-457-5577",
            "fax_number": "770-457-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL BUCOVETSKY, PSY.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-02",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "BUCOVETSKY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "770-457-5577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253866155A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mia J. Robinson, M.D., LLC
• Ruoyu Miao, MD
• Michael & Michael Counseling & Consulting
• Michael a Bens DMD PC
• Michael a. Haberman, MD, PC
• Michael D. Randell, M.D., P.C. (OBGYN Atlanta)
• Michael E Rinow MD PC
• Michael J Grundy MD PC
• Michael T Holvick DPM PC (Piedmont Podiatry)
• Abraham W Michael, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.