ROSWELL PSYCHIATRIC SERVICES PC NPI 1114251188

NPI Information

  • NPI: 1114251188
  • Provider Name: ROSWELL PSYCHIATRIC SERVICES, PC
  • Classification: Psychiatry & Neurology - 2084P0804X
  • Specialization: Child & Adolescent Psychiatry
  • Entity Type: Organization
  • Address: 77 E CROSSVILLE RD
    STE. 206
    ROSWELL, GA
    ZIP 30075
  • Phone: (770) 552-4655

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NPI Details

ROSWELL PSYCHIATRIC SERVICES, PC is a child and adolescent psychiatry psychiatry neurology in Roswell, GA. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. ROSWELL PSYCHIATRIC SERVICES, PC NPI is 1114251188. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

77 E CROSSVILLE RD
STE. 206
ROSWELL, GA
ZIP 30075-815
Phone: (770) 552-4655
Fax: (770) 552-4282

The provider's authorized official is Consuelo Reddick .
The authorized official title is Owner and has the following contact phone number (770) 552-4655.

The enumeration date for this NPI number is 9/24/2009 and was last updated on 9/24/2009.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatry044067GEORGIANo
22084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry044067GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C75884MEDICARE UPINGEORGIA

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: 11/21/2025

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