Peachtree Pediatric Psychology, LLC

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

3672 Issued in GA

Legal business name

PEACHTREE PEDIATRIC PSYCHOLOGY, LLC

Practice address

750 Hammond Drive
BLDG 7, Ste 200
Atlanta, GA 30328

Phone

(404) 796-7777

NPI assigned

Apr 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Avital K Cohen, PSY.D.NPI 1184870453

Title

Licensed Psychologist

Phone

(404) 796-7777

Specialties & licenses 1

Addresses

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Avital Karmel Cohen

  • Clinical Psychologist
  • Atlanta, GA
  • NPI 1184870453
  NPD Authorized official
• April Coleman, PSY.D.

  • Clinical Psychologist
  • Atlanta, GA
  • NPI 1336557024
  NPD (past)
• Joonsung Joshua Kim, PHD

  • Psychologist
  • Atlanta, GA
  • NPI 1972225258
  NPD (past)
• Marianne Vaniman, CRC, LPC

  • Mental Health Counselor
  • Atlanta, GA
  • NPI 1477981785
  NPD (past)
• Ann Claudette Waters, LPC

  • Professional Counselor
  • Tucker, GA
  • NPI 1346259264
  NPD (past)
• Asher Lindenbaum

  • Clinical Child & Adolescent Psychologist
  • Brighton, MA
  • NPI 1073980488
  NPD (past)

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1861998585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 HAMMOND DRIVE",
            "address_2": "BLDG 7, STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30328",
            "telephone_number": "404-796-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HAMMOND DRIVE",
            "address_2": "BLDG 7, STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30328",
            "telephone_number": "404-796-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE PEDIATRIC PSYCHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "AVITAL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "404-796-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "GA",
            "license": "3672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peachtree Orthopaedic Clinic, P.a..
• Peachtree Orthopaedic Clinic, PC
• Peachtree Orthopaedic Surgery Center at Perimeter
• Peachtree Orthopaedic Surgery Center at Piedmont LLC
• Peachtree Park Pediatrics, LLP
• Peachtree Physical Medicine Group
• Peachtree Piedmont Pathology PC
• Peachtree Plastic Surgery
• Peachtree Psychiatric Professionals PC
• Peachtree Psychiatric Professionals, PC

• All providers in Atlanta, GA
• Intellectual & Developmental Disabilities Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; 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.