Jason A Andersen, PSY.D

Primary specialty

Family PsychologistTaxonomy code 103TF0000X

License

3325 Issued in GA

Practice address

120 E Trinity PL
Decatur, GA 30030-3302

Phone

(404) 668-3766

NPI assigned

Oct 26, 2009

Last updated

Oct 26, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Andy Andersen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1740516731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E TRINITY PL",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303302",
            "telephone_number": "404-668-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E TRINITY PL",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303302",
            "telephone_number": "404-668-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "JASON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "3325",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "3325",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "GA",
            "license": "3325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDY",
            "last_name": "ANDERSEN",
            "prefix": "DR.",
            "credential": "PSY.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Matthew Peter Anani
• Katrina Rowell Anastasia, PA
• Tricia Anbinder, LCSW
• Anchor Home Healthcare Services, Inc.
• Anchor RX LLC (Anchor Pharmacy)
• Amina Anderson, N/A
• Andrew Anderson
• Barbara Jane Anderson, PA-C
• Barry Robert Anderson, PA
• Benjamin G Anderson, PAA

• Family Psychologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Family Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.