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PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES LLC NPI 1689198194


NPI Information

NPI: 1689198194
Provider Name: PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES LLC

Doing Business As: P.A.C.E.S., LLC

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
2945 WALTON WAY
AUGUSTA, GA
ZIP 30909
Phone: (706) 842-3279
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PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES LLC is a clinical psychologist in Augusta, GA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES LLC NPI is 1689198194. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As P.a.c.e.s., Llc.

The provider's business location address is:

2945 WALTON WAY
AUGUSTA, GA
ZIP 30909-827
Phone: (706) 842-3279
Fax: (706) 842-3272

The provider's authorized official is Stephanie Anne Northington .
The authorized official title is Psychologist/partner and has the following contact phone number (706) 842-3272.

The enumeration date for this NPI number is 7/27/2017 and was last updated on 7/8/2021.


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
1103TC0700XPsychologistClinicalGEORGIAYes
2225X00000XOccupational TherapistNo
3235Z00000XSpeech-Language PathologistGEORGIANo
4103K00000XBehavior AnalystGEORGIANo
5106S00000XBehavior TechnicianGEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11386012573OTHERGEORGIAOCCUPATIONAL THERAPY
21457632150OTHERGEORGIAPSYCHOLOGY
31700123163OTHERGEORGIASPEECH THERAPY

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.