VIRGINIA L GOETSCH, PH.D., LLC (NPI# 1407105703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407105703 |
| Entity Type | Organization |
| Organization Name | VIRGINIA L GOETSCH, PH.D., LLC |
| Other Organization Name | VIRGINIA L. GOETSCH, PH.D. |
| Practice Address |
775 Commerce Dr Suite 903 Decatur GA 30030-2620 |
| Mailing Address |
5282 Hickory Walk Ter Sw Conyers GA 30094-4757 |
| Practice Telephone | 7703013578 |
| Practice Fax Number | 4046385293 |
| Mailing Telephone | 7703013578 |
| Mailing Fax Number | 4046385293 |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-11-01 |
| Authorized Official Name | DR. VIRGINIA L GOETSCH (PRESIDENT) |
| Authorized Official Telephone | 7703013578 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2269 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | CAQH | 11511070 | 01 |
| GA | 000820817C | 05 |
| Other Name | Type Code |
|---|---|
| Virginia L. Goetsch, Ph.D. | Doing Business As Name - Organization |
| Street Address |
775 COMMERCE DR SUITE 903 |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-2620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280709 | Imani Psychological Services, Inc | Psychologist | 315 W Ponce De Leon Ave Ste 725, Decatur, GA 30030-2464 | 2019-11-20 |
| 1326513102 | Brittany Denise Baker | Psychologist | 1670 Clairmont Rd Rm 3b250, Decatur, GA 30033-4004 | 2018-10-09 |
| 1194228460 | Amy Elizabeth Wingard | Psychologist | 2366 Harrington Dr, Decatur, GA 30033-4902 | 2018-03-13 |
| 1386016301 | Christopher Awosika | Psychologist | 2848 Vining Ridge Ter, Decatur, GA 30034-7500 | 2015-10-29 |
| 1477976173 | Rhea Gordon Phd LLC | Psychologist | 1439 Mclendon Drive, Decatur, GA 30033-1841 | 2014-01-31 |
| 1093054413 | Life Center Counseling and Resources | Psychologist | 1 W Court Sq, Suite 750, Decatur, GA 30030-2538 | 2013-02-05 |
| 1376896696 | Delia L Lang | Psychologist | 2440 Lawrenceville Hwy Ste 200, Decatur, GA 30033-3267 | 2012-10-24 |
| 1801022413 | Lisa Clark Enterprises, Inc | Psychologist | 2785 Lawrenceville Hwy Ste 207, Decatur, GA 30033-2515 | 2009-06-09 |
| 1114196912 | Ausborn Behavioral Care, P.C. | Psychologist | 1456 Mclendon Dr Ste B, Decatur, GA 30033-1848 | 2008-02-26 |
| 1851509962 | David George Morgan | Psychologist | 867 Vistavia Cir, Decatur, GA 30033-3409 | 2007-05-21 |
| Find all providers in DECATUR | ||||
Please comment or provide details below to improve the information on VIRGINIA L GOETSCH, PH.D., 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.