Active NPI
Pcap Inc
- Clinical Psychologist
- Athens, GA
National Provider Identifier
1760614119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 821
- Legal business name
- PCAP INC
- Practice address
- 215 Hawthorne Park Ste a
Athens, GA 30606-2164 - Phone
- (706) 546-9880
- NPI assigned
- Aug 19, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Cardozo, ED.D.
- Title
- President
- Phone
- (706) 546-9880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 821 | GA | Primary |
Addresses
Primary practice location
215 Hawthorne Park Ste a
Athens, GA 30606-2164
Mailing address
215 Hawthorne Park Ste a
Athens, GA 30606-2164
Phone (706) 546-9880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000348323A | Medicaid | GA |
National Provider Directory
National Provider DirectoryLocations
215 Hawthorne Park
Ste A
Athens, GA 30606
Phone (706) 353-3794
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Athens, GA
- NPI 1114029279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1266192000000",
"number": "1760614119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 HAWTHORNE PARK STE A",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062164",
"telephone_number": "706-546-9880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 HAWTHORNE PARK STE A",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062164",
"telephone_number": "706-546-9880"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PCAP INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-08-19",
"last_updated": "2010-02-15",
"status": "A",
"authorized_official_last_name": "CARDOZO",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "706-546-9880",
"authorized_official_credential": "ED.D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "821",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000348323A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.