Child & Adolescent Resource, P.C.
Organization Active NPI Psychologist · Madison, GA
NPI 1962576314 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1962576314
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- License
- 1935 (GA)
- Legal business name
- CHILD & ADOLESCENT RESOURCE, P.C.
- Practice address
- 1200 Confederate Rd
Madison, GA 30650-2252 - Phone
- (706) 342-3130
- NPI assigned
- Nov 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Diedrea Claxton
- Title
- Licensed Psychologist
- Phone
- (706) 342-3130
Practitioners 2
-
Diedrea Steverson Claxton, PH.D.
-
Frusanna Booth Hayes, ED.D.
National Provider Directory
Locations
1200 Confederate Rd
Madison, GA 30650
Phone (706) 342-3130
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | 1935 | GA | Yes |
Addresses
Primary practice location
1200 Confederate Rd
Madison, GA 30650-2252
Mailing address
1200 Confederate Rd
Madison, GA 30650-2252
Phone (706) 342-3130
Other providers in Madison, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.