Individual provider Active NPI

Connie Schenk, PHD

  • Clinical Psychologist
  • Thomasville, GA
National Provider Identifier
1710050919
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY5933 Issued in FL
Practice address
1213 E Jackson St
Thomasville, GA 31792-4748
Phone
(229) 228-1950
Fax
(229) 228-1978
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychologist 103TF0200X PSY002406 GA
Forensic Psychologist 103TF0200X PY5933 FL
Clinical Psychologist 103TC0700X PSY002406 GA
Clinical Psychologist 103TC0700X PY5933 FL Primary

Addresses

Primary practice location

1213 E Jackson St
Thomasville, GA 31792-4748

Mailing address

PO Box 1403
Thomasville, GA 31799-1403
Phone (229) 228-1950

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
PY5933FLMDClinical Psychologist
PSY002406GAMDForensic Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Psychological Services Forensic 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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1710050919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1403",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317991403",
            "telephone_number": "229-228-1950",
            "fax_number": "229-228-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 E JACKSON ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924748",
            "telephone_number": "229-228-1950",
            "fax_number": "229-228-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENK",
        "first_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "GA",
            "license": "PSY002406",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "FL",
            "license": "PY5933",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002406",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.