Cheryl Coletta Psy D PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

CHERYL COLETTA PSY D PC

Practice address

125 Townpark Dr NW Ste 300
Kennesaw, GA 30144-3231

Phone

(561) 279-5599

NPI assigned

Oct 22, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Cheryl Coletta, PSY.D.NPI 1356774061

Title

Owner/President

Phone

(561) 279-5599

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

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

• Cheryl Nancy Coletta, PSY.D.

  • Psychologist
  • Kennesaw, GA
  • NPI 1356774061
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1922829068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 TOWNPARK DR NW STE 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443231",
            "telephone_number": "561-279-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 TOWNPARK DR NW STE 300",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443231",
            "telephone_number": "561-279-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERYL COLETTA PSY D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "COLETTA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "561-279-5599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.