NPIMap

Organization Active NPI

Premier Psychological Center, Inc.

  • Clinical Psychologist
  • Jonesboro, GA
National Provider Identifier
1962645796
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY002435 Issued in GA
Legal business name
PREMIER PSYCHOLOGICAL CENTER, INC.
Practice address
2268 Mount Zion Rd
Jonesboro, GA 30236-2528
Phone
(770) 603-3400
Fax
(770) 603-3404
NPI assigned
Apr 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Authorized official

Name
Dr. Valerie McAdams, PSY.DNPI 1992951289
Title
Psychologist
Phone
(770) 603-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY002435 GA Primary

Addresses

Primary practice location

2268 Mount Zion Rd
Jonesboro, GA 30236-2528

Mailing address

2268 Mount Zion Rd
Jonesboro, GA 30236-2528
Phone (770) 603-3400

Other identifiers 3

IdentifierTypeStateIssuer
000884078BMedicaidGA
000900589DMedicaidGA
824394587AMedicaidGA

National Provider Directory

National Provider Directory

Locations

2268 Mount Zion Rd
Jonesboro, GA 30236
Phone (404) 804-3639

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1962645796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2268 MOUNT ZION RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362528",
            "telephone_number": "770-603-3400",
            "fax_number": "770-603-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2268 MOUNT ZION RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362528",
            "telephone_number": "770-603-3400",
            "fax_number": "770-603-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PSYCHOLOGICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "MCADAMS",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "770-603-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000884078B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000900589D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "824394587A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.