Georgia Psychological Consultants

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

999 Issued in GA

Legal business name

GEORGIA PSYCHOLOGICAL CONSULTANTS

Practice address

600 Kennesaw Ave NW
Suite 300
Marietta, GA 30060-6988

Phone

(770) 428-6698

NPI assigned

Aug 16, 2007

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leisa Ann Bailey, PHDNPI 1376695288

Title

President/Clinical Psychologist

Phone

(770) 428-6698

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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.

• Leisa Ann Bailey, PH.D.

  • Clinical Psychologist
  • Marietta, GA
  • NPI 1376695288
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1891987590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WHITLOCK AVE NW",
            "address_2": "SUITE 320",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645455",
            "telephone_number": "770-428-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 KENNESAW AVE NW",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300606988",
            "telephone_number": "770-428-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PSYCHOLOGICAL CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "LEISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "770-428-6698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.