Organization Active NPI

Counseling and Psychological Services - Atlanta

  • Psychologist
  • Atlanta, GA
National Provider Identifier
1730557919
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY003640 Issued in GA
Legal business name
COUNSELING AND PSYCHOLOGICAL SERVICES - ATLANTA
Practice address
250 Georgia Ave SE
Suite 205
Atlanta, GA 30312-3046
Phone
(404) 419-7895
Fax
(404) 419-7891
NPI assigned
Sep 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Authorized official

Name
Tisha M Johnson, PSYDNPI 1629274089
Title
Clinical Psychologist/Owner
Phone
(404) 419-7895

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY003640 GA Primary

Addresses

Primary practice location

250 Georgia Ave SE
Suite 205
Atlanta, GA 30312-3046

Mailing address

PO Box 950032
Atlanta, GA 30377-2032
Phone (404) 419-7895

Other names 1

  • CAPS - Atlanta Other name

National Provider Directory

National Provider Directory

Locations

250 Georgia Ave SE
Ste 205
Atlanta, GA 30312
Phone (404) 419-7895

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1730557919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950032",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303772032",
            "telephone_number": "404-419-7895",
            "fax_number": "404-419-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GEORGIA AVE SE",
            "address_2": "SUITE 205",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123046",
            "telephone_number": "404-419-7895",
            "fax_number": "404-419-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING AND PSYCHOLOGICAL SERVICES - ATLANTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TISHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "404-419-7895",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAPS - Atlanta",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 4, 2015; 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.