Individual provider Active NPI

Cynthia Diane Kreutzer, PSYD

  • Clinical Psychologist
  • Suwanee, GA
National Provider Identifier
1720249642
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY003180 Issued in GA
Practice address
950 Scales Rd
Ste 302
Suwanee, GA 30024-4340
Phone
(404) 994-5000
Fax
(888) 264-8367
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY003180 GA Primary

Addresses

Primary practice location

950 Scales Rd
Ste 302
Suwanee, GA 30024-4340

Mailing address

950 Scales Rd
Ste 302
Suwanee, GA 30024-4340
Phone (404) 994-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141022002196 GA Practitioner - Clinical Psychologist 3173744802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Sreedevi Vayalapalli, MD,PCGroup PAC ID 2769635747, 2 clinicians

Practice addresses (Care Compare)

950 Scales Rd
Suite 302
Suwanee, GA 30024-4342
Phone (404) 994-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY003180GAMDAddiction (Substance Use Disorder) Counselor

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1720249642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 SCALES RD",
            "address_2": "STE 302",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244340",
            "telephone_number": "404-994-5000",
            "fax_number": "888-264-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 SCALES RD",
            "address_2": "STE 302",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244340",
            "telephone_number": "404-994-5000",
            "fax_number": "888-264-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREUTZER",
        "first_name": "CYNTHIA",
        "middle_name": "DIANE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.