DR. THERESA WELLES (NPI# 1851719710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851719710 |
| Entity Type | Individual |
| Full Name | DR. THERESA WELLES |
| Other Name | THERESA LOPEZ |
| Credential | PH.D. |
| Practice Address |
3650 Steve Reynolds Blvd. Duluth GA 30096 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305 |
| Practice Telephone | 7709316200 |
| Practice Fax Number | 7709316042 |
| Mailing Telephone | 4043647070 |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2014-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY003526 | GA | Behavioral Health & Social Service Providers |
| Street Address |
3650 STEVE REYNOLDS BLVD. |
| City | DULUTH |
| State | GA |
| Zip Code | 30096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659360568 | William Moten Craven | Orthopaedic Surgery | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2005-10-14 |
| 1275805970 | Frances Ann Lanza | Social Worker | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2012-01-27 |
| 1750676060 | Andrea Giardina Hill | Optometrist | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2011-06-15 |
| 1588977557 | Ammar Divan | Anesthesiology | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2010-07-20 |
| 1639493224 | Nancy Huynh | Specialist | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2010-03-25 |
| 1730332131 | Lisa Bazemore Rivera | Psychiatry & Neurology | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2008-10-29 |
| 1891957528 | Ana Silvia Grosso | Pediatrics | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2008-06-25 |
| 1316107253 | Hernan Dario Urrego | Surgery | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2008-06-13 |
| 1417134545 | Jada R. Olderman | Pediatrics | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2008-01-31 |
| 1508042268 | Carolyn Bray Hebson | Specialist | 3650 Steve Reynolds Blvd., Kaiser Permanente Gwinnett Medical Center, Duluth, GA 30096 | 2008-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| 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 |
|---|---|---|---|---|
| 1801493952 | Michelle Brownfield | Psychologist | 606 Spear Ave, Duluth, MN 55803-2154 | 2020-10-01 |
| 1770143331 | James Vincent Shreffler | Psychologist | 324 W Superior St Ste 620, Duluth, MN 55802-1723 | 2019-06-17 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1437447992 | Michelle Simon | Psychologist | 1005 W Morgan St, Duluth, MN 55811-4424 | 2011-07-19 |
| 1215161823 | Jude Martin Henningsgaard | Psychologist | 405 E Superior St, Duluth, MN 55802-2240 | 2009-05-11 |
| 1518143999 | Claudia Virginia Weber | Psychologist | 4298 Charles Rd, Duluth, MN 55803-1270 | 2008-01-15 |
| 1356486153 | Penelope Jean Gooch | Psychologist | 101 W 2nd Street, Suite 100 Northern Lights Counseling Center, Duluth, MN 55802 | 2007-02-20 |
| 1215070073 | Marcus Peter Desmonde | Psychologist | 716 Medical Arts Bldg, Duluth, MN 55802-1721 | 2007-02-14 |
| 1013054642 | Kelly Jean Ravenfeather | Psychologist | 230 E Superior St Ste 101, Duluth, MN 55802-2104 | 2007-01-31 |
| 1417009804 | Susan Ruth Hall | Psychologist | 1707 Miller Trunk Hwy, Duluth, MN 55811-1880 | 2007-01-17 |
| Find all providers in DULUTH | ||||
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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.