NPIMap

Organization Active NPI

Jennifer Smith, Psy.D., P.C.

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1992960199
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3053 Issued in GA
Legal business name
JENNIFER SMITH, PSY.D., P.C.
Practice address
3308A Northcrest Rd
Atlanta, GA 30340-4012
Phone
(404) 808-0101
NPI assigned
Jul 28, 2008
Last updated
Jul 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Dr. Jennifer SmithNPI 1770632010
Title
Owner/Psychologist
Phone
(404) 808-0101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 3053 GA
Adult Development & Aging PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0700X 3053 GA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 3053 GA Primary

Addresses

Primary practice location

3308A Northcrest Rd
Atlanta, GA 30340-4012

Mailing address

3308A Northcrest Rd
Atlanta, GA 30340-4012
Phone (404) 808-0101

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1992960199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308A NORTHCREST RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303404012",
            "telephone_number": "404-808-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308A NORTHCREST RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303404012",
            "telephone_number": "404-808-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER SMITH, PSY.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "404-808-0101",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "3053",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "GA",
            "license": "3053",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "3053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.