TANYA THERIOT, PSY.D., P.C. (NPI# 1124251590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124251590 |
| Entity Type | Organization |
| Organization Name | TANYA THERIOT, PSY.D., P.C. |
| Practice Address |
3939 Roswell Rd Suite 185 Marietta GA 30062-6251 |
| Mailing Address |
Po Box 724384 Atlanta GA 31139-1384 |
| Practice Telephone | 7703101792 |
| Practice Fax Number | 7709451211 |
| Mailing Telephone | 7703101792 |
| Mailing Fax Number | 4049451211 |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2009-09-01 |
| Authorized Official Name | DR. TANYA SAPORITA THERIOT (OWNER, CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 7703101792 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY002887 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GU | 409047010A | 05 |
| Street Address |
3939 ROSWELL RD SUITE 185 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-6251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346242229 | Susan Gail Staviss | Pediatrics | 3939 Roswell Rd, Suite 300, Marietta, GA 30062-6251 | 2005-08-11 |
| 1578049656 | Christine Ghilain | Clinical Neuropsychologist | 3939 Roswell Rd, Marietta, GA 30062-6251 | 2018-07-12 |
| 1841722212 | Southeast Integrative Medicine | Naturopath | 3939 Roswell Rd, Suite 240, Marietta, GA 30062-6251 | 2017-04-03 |
| 1780924043 | Wellstar Medical Group, LLC | Pediatrics | 3939 Roswell Rd, Suite 300, Marietta, GA 30062-6251 | 2013-02-25 |
| 1275814964 | Wellstar Medical Group, LLC | Family Medicine | 3939 Roswell Rd, Suite 240, Marietta, GA 30062-6251 | 2011-09-08 |
| 1952464505 | Marietta Eye Optical Inc | Durable Medical Equipment & Medical Supplies | 3939 Roswell Rd, Suite 100, Marietta, GA 30062-6251 | 2006-12-18 |
| 1689736860 | Marietta Eye Clinic, Pa | Optometrist | 3939 Roswell Rd, Suite 100, Marietta, GA 30062 | 2006-12-14 |
| 1992866818 | Robin Lisa King | Social Worker | 3939 Roswell Rd, Suite 185, Marietta, GA 30062-6251 | 2006-12-13 |
| 1851468078 | Parkway Therapy Services, Inc. Dba East Cobb Physical Therapy | Physical Therapist | 3939 Roswell Rd, Suite 160, Marietta, GA 30062-6251 | 2006-11-30 |
| 1700958394 | Sona P Amin | Internal Medicine | 3939 Roswell Rd, Suite 110, Marietta, GA 30062-6251 | 2006-11-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356848485 | Valerie Parker, Psy.d., Inc. | Psychologist | 1744 Roswell Rd Ste 200, Marietta, GA 30062-3979 | 2018-04-05 |
| 1750831301 | Quaneecia Rainey | Psychologist | 55 Whitcher St Ne Ste 400, Marietta, GA 30060-1129 | 2016-10-06 |
| 1760727762 | Christy Jaffe | Psychologist | 459 Old Canton Rd, Marietta, GA 30068-3267 | 2012-12-02 |
| 1700111721 | Dongwook Lee | Psychologist | 3939 Roswell Rd Ste 200, Marietta, GA 30062 | 2009-10-08 |
| 1326250978 | Beverly Dawn Brooks | Psychologist | 660 Village Trce Ne Bldg 18, Paper Mill Village Office Park, Marietta, GA 30067-4081 | 2007-05-04 |
| 1023134244 | Cheryl Anderson Williams | Psychologist | 2625 Sandy Plains Rd, Suite 104, Marietta, GA 30066-4260 | 2007-03-21 |
| 1275613481 | Sheryl K. White | Psychologist | 416 1/2 Colegate Dr, Marietta, OH 45750-9549 | 2006-10-16 |
| 1003822073 | Jeffrey John Pipe | Psychologist | 127 Church St Ne, Suite 350, Marietta, GA 30060-8637 | 2006-07-31 |
| 1780617159 | Marc Isralsky, PC | Psychologist | 840 Church St Ne, Bldg. F, Marietta, GA 30060-8936 | 2006-07-09 |
| 1780614636 | Susan Z. Volentine | Psychologist | 122 Cherry St Ne, Marietta, GA 30060-7206 | 2006-07-04 |
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| 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.