Organization Active NPI

Charting Your Course, LLC

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1750597530
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY002432 Issued in GA
Legal business name
CHARTING YOUR COURSE, LLC
Practice address
1776 Century Blvd NE
Suite a
Atlanta, GA 30345-3397
Phone
(404) 579-1987
Fax
(770) 643-3944
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Authorized official

Name
Dr. Hamid Mirsalimi, PH.D.NPI 1205041100
Title
Owner
Phone
(404) 579-1987

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY002432 GA Primary

Addresses

Primary practice location

1776 Century Blvd NE
Suite a
Atlanta, GA 30345-3397

Mailing address

12 Norcross St
Suite 200C
Roswell, GA 30075-7409
Phone (404) 579-1987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100503000147 GA Part B Supplier - Clinic/Group Practice 9032247655 Receives reassigned benefits from 1 practitioner
Practice locations: Roswell, GA

National Provider Directory

National Provider Directory

Locations

1784 Century Blvd NE
Ste A
Atlanta, GA 30345
Phone (402) 370-6778

2940 Johnson Ferry Rd
Ste B279
Marietta, GA 30062

981 Canton St
Ste 200C
Roswell, GA 30075
Phone (404) 579-1987

12 Norcross St
Ste 200C
Roswell, GA 30075

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": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1750597530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 NORCROSS ST",
            "address_2": "SUITE 200C",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300757409",
            "telephone_number": "404-579-1987",
            "fax_number": "770-643-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 CENTURY BLVD NE",
            "address_2": "SUITE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453397",
            "telephone_number": "404-579-1987",
            "fax_number": "770-643-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTING YOUR COURSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "MIRSALIMI",
        "authorized_official_first_name": "HAMID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-579-1987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.