Active NPI
John Petzelt, PH.D.
- Clinical Psychologist
- Dunwoody, GA
National Provider Identifier
1750333068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY000433
- Practice address
- 1830 Independence SQ
Suite a
Dunwoody, GA 30338-5150 - Phone
- (770) 394-8845
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY000433 | GA | Primary |
Addresses
Primary practice location
1830 Independence SQ
Suite a
Dunwoody, GA 30338-5150
Mailing address
1830 Independence SQ
Suite a
Dunwoody, GA 30338-5150
Phone (770) 394-8845
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY000433 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1750333068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 INDEPENDENCE SQ",
"address_2": "SUITE A",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303385150",
"telephone_number": "770-394-8845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 INDEPENDENCE SQ",
"address_2": "SUITE A",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303385150",
"telephone_number": "770-394-8845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETZELT",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY000433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunwoody, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.