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PEACHTREE FAMILY PSYCHIATRY CLINIC NPI 1487059564


NPI Information

NPI: 1487059564
Provider Name: PEACHTREE FAMILY PSYCHIATRY CLINIC
Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

Address:
1776 PEACHTREE ST NW
SUITE 310 NORTH
ATLANTA, GA
ZIP 30309
Phone: (404) 249-8496
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PEACHTREE FAMILY PSYCHIATRY CLINIC is a prescribing (medical) psychologist in Atlanta, GA. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. PEACHTREE FAMILY PSYCHIATRY CLINIC NPI is 1487059564. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1776 PEACHTREE ST NW
SUITE 310 NORTH
ATLANTA, GA
ZIP 30309-307
Phone: (404) 249-8496

The provider's authorized official is Yassar Kanawati .
The authorized official title is Psychiatrist and has the following contact phone number (770) 380-0635.

The enumeration date for this NPI number is 10/30/2014 and was last updated on 10/30/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TP0016XPsychologistPrescribing (Medical)49237GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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