SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC (NPI# 1114085743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114085743 |
| Entity Type | Organization |
| Organization Name | SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC |
| Practice Address |
2625 Sandy Plains Rd Ste 202 Secondary Location Marietta GA 30066-4291 |
| Mailing Address |
Po Box 1078 Lithia Springs GA 30122-1078 |
| Practice Telephone | 7707320983 |
| Practice Fax Number | 7707321283 |
| Mailing Telephone | 7707320982 |
| Mailing Fax Number | 7707321283 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-08-10 |
| Authorized Official Name | DR. DAVID CLYDE MARTIN (OWNER/PARTNER) |
| Authorized Official Telephone | 7707320982 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY001157 | GA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
CSW000729 | GA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY001373 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467562827 | Sweetwater Psychological Associates, LLC | Psychologist | 560 Thornton Rd, Suite 106, Lithia Springs, GA 30122-1655 | 2006-08-30 |
| Street Address |
2625 SANDY PLAINS RD STE 202 SECONDARY LOCATION |
| City | MARIETTA |
| State | GA |
| Zip Code | 30066-4291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598253684 | Comfort Community Center, LLC | Skilled Nursing Facility | 2440 Sandy Plains Road, Blvd 21, Suite 100, Marietta, GA 30066 | 2018-04-25 |
| 1538681994 | Passionate Care | In Home Supportive Care | 1110 Renfro Ln., Marietta, GA 30066 | 2017-07-07 |
| 1437510443 | Steven Caras | Internal Medicine | 2682 Bonaire Terrace, Marietta, GA 30066 | 2016-03-18 |
| 1275918781 | Latifat Bolajoko Asemota | Nurse Practitioner | 410 Nottingham Dr, Marietta, GA 30066 | 2015-07-26 |
| 1497094205 | Changing Phases Behavioral Support, Inc | Internal Medicine | 3655 Canton Rd Ste 201, Marietta, GA 30066 | 2013-02-14 |
| 1659618916 | Alison Nicole Sims | Occupational Therapist | 2465 Canopy Drive, Marietta, GA 30066 | 2013-01-07 |
| 1790044907 | Antoine Jose Davenport | Massage Therapist | 4686 Jamerson Creek Dr, Marietta, GA 30066 | 2012-05-08 |
| 1174898548 | Angel Elizabeth Nofziger | Nurse Practitioner | 3750 Palladian Village Dr Ste 300, Marietta, GA 30066 | 2012-03-18 |
| 1912298019 | Nancy Jean Slack | Pharmacist | 2833 Canton Road, Marietta, GA 30066 | 2011-04-22 |
| 1336456078 | Mario B Miller Sr. | Chiropractor | 50 Barrett Parkway, Suite 3005#126, Marietta, GA 30066 | 2010-09-01 |
| Find all providers in zip 30066 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790245173 | Hopebridge, LLC | Psychologist | 2651 Dallas Hwy Sw, Marietta, GA 30064-2541 | 2019-03-22 |
| 1053812537 | Carmen Julia Neyra | Psychologist | 4939 Lower Roswell Rd Bldg C, Marietta, GA 30068-4338 | 2018-02-21 |
| 1467903609 | Alesya Korey | Psychologist | 821 Devonwood Trl Nw, Marietta, GA 30064-5439 | 2016-10-24 |
| 1174953780 | Marietta Associated Psychological Services Inc | Psychologist | 2501 E Piedmont Rd Ste 147, Marietta, GA 30062-7754 | 2013-11-18 |
| 1902248024 | Kavita Joshi Subrahmanian | Psychologist | 1778 Millhouse Run, Marietta, GA 30066-8012 | 2013-07-18 |
| 1154688877 | Terry A Crump | Psychologist | 134 Powers Ferry Rd Se Ste B, Marietta, GA 30067-7589 | 2012-04-19 |
| 1710126461 | Susan Sevier Buffington | Psychologist | 4608 Lower Roswell Rd, Marietta, GA 30068-4237 | 2009-02-19 |
| 1962655324 | Kenneth C Molkner Md PC | Psychologist | 2501 Windy Hill Rd Se, Suite 245, Marietta, GA 30067-8663 | 2008-10-29 |
| 1205044278 | Lisa Rubin | Psychologist | 282 Village Pkwy Ne, Marietta, GA 30067-4062 | 2007-05-21 |
| 1588876221 | Richard E. Shook, Ph.d., P.C. | Psychologist | 127 Cherry Street, Marietta, GA 30060 | 2007-05-04 |
| Find all providers in MARIETTA | ||||
Please comment or provide details below to improve the information on SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.