Jill C Anderson, PSYD
Individual provider Active NPI Clinical Psychologist · Sugar Hill, GA
NPI 1972805786 · NPPES record last updated Aug 16, 2022
Key facts
- NPI
- 1972805786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY003030 (GA)
- Practice address
- 1400 Buford Hwy Ste G7
Sugar Hill, GA 30518-8727 - Phone
- (404) 542-5287
- Fax
- (888) 485-5215
- NPI assigned
- Nov 30, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY003030 | GA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corcair Pyschological Services, LLC | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY003030 | GA | Yes |
Addresses
Primary practice location
1400 Buford Hwy Ste G7
Sugar Hill, GA 30518-8727
Mailing address
1400 Buford Hwy Ste G7
Sugar Hill, GA 30518-8727
Phone (404) 542-5287
Other providers in Sugar Hill, GA
- Aegis Healthworks LLC
- Aethel Analytics LLC
- Arean Afghan
- Maria Ahmed
- Harrison Ellis Aiken
- Olivia Grace Andrews
- Matilda Mabel Antwi
- Ap Speech Therapy, LLC
- Lena Aquino
- Gabriela Arana
All providers in Sugar Hill, GA · Clinical Psychologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2022. 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.