ATHENS PSYCHOLOGICAL SERVICES, LLC (NPI# 1457627044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457627044 |
| Entity Type | Organization |
| Organization Name | ATHENS PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
1090 Founders Blvd Ste. B Athens GA 30606-6163 |
| Practice Telephone | 7065488697 |
| Practice Fax Number | 7065488698 |
| Mailing Telephone | 7065488697 |
| Mailing Fax Number | 7065488698 |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |
| Authorized Official Name | MR. JOSEPH E. MASON (CEO) |
| Authorized Official Telephone | 7065488697 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | PSY002674 | GA | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PSY002674 | GA | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY002674 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MAGELLAN | 556185000 | 01 | |
| AMERIGROUP | 10034544 | 01 | |
| GA | 050836150C | 05 |
| Street Address |
1090 FOUNDERS BLVD STE. B |
| City | ATHENS |
| State | GA |
| Zip Code | 30606-6163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194019778 | Hannah Harwood Nelson | Psychologist | 1090 Founders Blvd, Suite B, Athens, GA 30606-6163 | 2011-06-01 |
| 1619458825 | Jason Benton LLC | Counselor | 1090 Founders Blvd, Athens, GA 30606-6163 | 2018-08-25 |
| 1073928669 | Jaclyn Peters | Psychologist | 1090 Founders Blvd, Suite B, Athens, GA 30606-6163 | 2014-06-23 |
| 1811319403 | Jason M. Nelson | Psychologist | 1090 Founders Blvd, Suite B, Athens, GA 30606-6163 | 2014-01-15 |
| 1104254598 | Millie S. Kelleher, Lcsw | Social Worker | 1090 Founders Blvd, Suite B, Athens, GA 30606-6163 | 2013-10-22 |
| 1821435652 | Millie Sue Kelleher | Social Worker | 1090 Founders Blvd, Suite B, Athens, GA 30606-6163 | 2013-06-03 |
| 1689920167 | Carolyn Patricia Barnes | Psychologist | 1090 Founders Blvd, Suite B, Athens, GA 30606-6163 | 2012-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816962 | Kofi Darkwa Seffah | Student in an Organized Health Care Education/Training Program | 1199 Prince Ave #70, 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-09-16 |
| 1831712363 | Rebecca John | Licensed Practical Nurse | 240 Mitchel Bridge Road, Athens, GA 30606 | 2020-05-19 |
| 1497375612 | Alfred Ka-shing Wong | Student in an Organized Health Care Education/Training Program | 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-04-17 |
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1255981700 | Carol Cameron Cready-pyle | Social Worker | 1551 Jennings Mill Pkwy Ste 1700, Athens, GA 30606 | 2019-09-17 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1760045223 | Dominic Ofosu Amakye | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue Suite 201, Athens, GA 30606 | 2019-04-19 |
| 1740740422 | Juan G Salazar Castillo | Student in an Organized Health Care Education/Training Program | Community Internal Medicine of Athens, 1500 Oglethorpe Ave Suite 200d, Athens, GA 30606 | 2019-03-20 |
| 1750869020 | Jennifer Emily Chapman | Physical Therapist | 1021 Parkway Blvd Ste 101, Athens, GA 30606 | 2018-07-30 |
| Find all providers in zip 30606 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538693254 | Rachel Yosick | Psychologist | 520 Wembley Cir, Sandy Springs, GA 30328-6753 | 2017-04-19 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1245655893 | Tiffany Gilmore Randell | Psychologist | 101 Devant Street, Office 401, Fayetteville, GA 30214 | 2014-02-19 |
| 1972927861 | Tyrone D. Lane Enterprises, Incorporated | Psychologist | 5304 Panola Industrial Boulevard, Suite L, Decatur, GA 30035 | 2014-02-12 |
| 1720409493 | Tonya Favors | Psychologist | 311 S Lee St, Apt C, Americus, GA 31709-3971 | 2013-12-26 |
| 1912336546 | Francine Adams | Psychologist | 324 Trace Ln, Lawrenceville, GA 30046-2896 | 2013-11-04 |
| 1447542691 | Erin Marie Jones | Psychologist | 1256 Briarcliff Rd Ne Ste 322e, Atlanta, GA 30306-2636 | 2011-05-06 |
| 1164729901 | Tiffany Whitworth | Psychologist | 4139 Hospital Dr Ne, Covington, GA 30014-2565 | 2011-02-14 |
| 1548573264 | Kimberley Blaker Saye | Psychologist | 4695 Mahonia Way Nw, Acworth, GA 30102-3575 | 2010-07-22 |
| 1316269350 | Caitlin Herzinger Delfs | Psychologist | 4994 Lower Roswell Rd Ste 10, Marietta, GA 30068-4332 | 2010-02-18 |
| Find all providers with the same taxonomy | ||||
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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.