Active NPI
Pamela Beth Collman, PHD
- Clinical Child & Adolescent Psychologist
- Richmond Hill, GA
National Provider Identifier
1992845499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PSY002520
- Practice address
- 3766 Hwy 17
Ste 104
Richmond Hill, GA 31324 - Phone
- (912) 756-7686
- Fax
- (912) 756-7856
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY002520 | GA | |
| Clinical Neuropsychologist | 103G00000X | PSY16357 | CA | |
| Clinical Psychologist | 103TC0700X | PSY002520 | GA | |
| Clinical Psychologist | 103TC0700X | PSY16357 | CA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY002520 | GA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY16357 | CA |
Addresses
Primary practice location
3766 Hwy 17
Ste 104
Richmond Hill, GA 31324
Mailing address
PO Box 1450
Richmond Hill, GA 31324
Phone (912) 756-7686
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 478168 | Other | GA | VALUE OPTIONS SOUTH WEST |
| 899577937B | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16357 | CA | MD | Clinical Psychologist |
| PSY002520 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441756800000",
"number": "1992845499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1450",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "31324",
"telephone_number": "912-756-7686",
"fax_number": "912-756-7856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3766 HWY 17",
"address_2": "STE 104",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "31324",
"telephone_number": "912-756-7686",
"fax_number": "912-756-7856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLMAN",
"first_name": "PAMELA",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2015-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "GA",
"license": "PSY002520",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY16357",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY002520",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY16357",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "GA",
"license": "PSY002520",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY16357",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS SOUTH WEST",
"identifier": "478168",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "899577937B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond Hill, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.