NPIMap

Organization Active NPI

Center for Family Psychiatry

  • Professional Counselor
  • Tyrone, GA
National Provider Identifier
1841379740
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC003153 Issued in GA
Legal business name
CENTER FOR FAMILY PSYCHIATRY
Practice address
120 Handley Rd
Suite 310
Tyrone, GA 30290-2177
Phone
(770) 486-1011
Fax
(770) 486-1067
NPI assigned
Nov 3, 2006
Last updated
Mar 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Kalika S Bhargave
Title
Office Manager
Phone
(770) 486-1011

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC003177 GA
Professional Counselor 101YP2500X LPC003153 GA Primary
Cognitive & Behavioral Psychologist 103TB0200X PSY002096 GA

Addresses

Primary practice location

120 Handley Rd
Suite 310
Tyrone, GA 30290-2177

Mailing address

120 Handley Rd
Suite 310
Tyrone, GA 30290-2177
Phone (770) 486-1011

Other identifiers 1

IdentifierTypeStateIssuer
076097468AMedicaidGA

National Provider Directory

National Provider Directory

Locations

120 Handley Rd
Ste 310
Tyrone, GA 30290
Phone (770) 301-1502

Practitioners & affiliated clinicians

Practitioners 4

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": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1841379740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HANDLEY RD",
            "address_2": "SUITE 310",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902177",
            "telephone_number": "770-486-1011",
            "fax_number": "770-486-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HANDLEY RD",
            "address_2": "SUITE 310",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902177",
            "telephone_number": "770-486-1011",
            "fax_number": "770-486-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR FAMILY PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "BHARGAVE",
        "authorized_official_first_name": "KALIKA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-486-1011"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC003177",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003153",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "GA",
            "license": "PSY002096",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076097468A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyrone, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.