NPIMap

Organization Active NPI

Peachtree Psychological Services, P.C.

  • Psychologist
  • Atlanta, GA
National Provider Identifier
1811101207
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY0001213 Issued in GA
Legal business name
PEACHTREE PSYCHOLOGICAL SERVICES, P.C.
Practice address
415 Stone Arbor CT SW
Atlanta, GA 30331-7652
Phone
(404) 344-3580
Fax
(404) 344-9826
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Myra N Burnett, PH.D.NPI 1528272911
Title
President
Phone
(404) 344-3580

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
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY0001213 GA Primary

Addresses

Primary practice location

415 Stone Arbor CT SW
Atlanta, GA 30331-7652

Mailing address

415 Stone Arbor CT SW
Atlanta, GA 30331-7652
Phone (404) 344-3580

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.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811101207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 STONE ARBOR CT SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317652",
            "telephone_number": "404-344-3580",
            "fax_number": "404-344-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 STONE ARBOR CT SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317652",
            "telephone_number": "404-344-3580",
            "fax_number": "404-344-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "MYRA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-344-3580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY0001213",
            "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 Aug 22, 2020; 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.