Timothy James Aycock, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1928 Issued in GA

Practice address

115 Habersham Dr
Fayetteville, GA 30214

Phone

(770) 461-9944

Fax

(770) 461-9779

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

A New Start Counseling Center IncGroup PAC ID 2466340310, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A New Start Counseling Center Inc

  • Psychologist
  • Fayetteville, GA
  • NPI 1477619195
  Medicare reassignment Care Compare group NPD
• Accordia Counseling Solutions

  • Counseling Psychologist
  • Fayetteville, GA
  • NPI 1518290857
  NPD (past) Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780752618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HABERSHAM DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-461-9944",
            "fax_number": "770-461-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HABERSHAM DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-461-9944",
            "fax_number": "770-461-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYCOCK",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "1928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00637788A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traci Autera, DC
• Lisa M Avery, M.D.
• Stephen Otieno Awuor, M.D.
• David Wayne Aycock, PHD
• Kristen J Aycock, PH.D.
• Kristin Renee Ayers, DPT
• Babbling Bunch Speech Therapy LLC
• S. Bernard Bagley, LCSW
• Amanda Sullivan Bahler, APRN
• Kendra Bailey-Lyon, PT

• Psychologist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.