Organization Active NPI

Pcap Inc

  • Clinical Psychologist
  • Athens, GA
National Provider Identifier
1760614119
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
821 Issued in GA
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

Updated by the provider on Feb 15, 2010

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)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
000348323AMedicaidGA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.