NPIMap

Organization Active NPI

LK Psych Health

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1770912420
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
LK PSYCH HEALTH
Practice address
675 Seminole Ave NE Ste 307
Atlanta, GA 30307-3416
Phone
(678) 701-9559
Fax
(855) 611-1918
NPI assigned
Nov 4, 2013
Last updated
Nov 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Linda Kondilis, PHDNPI 1063841344
Title
Clinical Psychologist
Phone
(678) 701-9559

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

675 Seminole Ave NE Ste 307
Atlanta, GA 30307-3416

Mailing address

675 Seminole Ave NE Ste 307
Atlanta, GA 30307-3416
Phone (678) 701-9559

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1770912420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 SEMINOLE AVE NE STE 307",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303073416",
            "telephone_number": "678-701-9559",
            "fax_number": "855-611-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 SEMINOLE AVE NE STE 307",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303073416",
            "telephone_number": "678-701-9559",
            "fax_number": "855-611-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LK PSYCH HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "KONDILIS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "678-701-9559",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "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 Nov 4, 2013; 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.