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MAYO PSYCHOLOGICAL SERVICES INC. NPI 1134367378


NPI Information

NPI: 1134367378
Provider Name: MAYO PSYCHOLOGICAL SERVICES, INC.
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
1640 POWERS FERRY RD SE
BLDG. 17, STE. 350
MARIETTA, GA
ZIP 30067
Phone: (770) 956-9212
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MAYO PSYCHOLOGICAL SERVICES, INC. is a clinical psychologist in Marietta, 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. MAYO PSYCHOLOGICAL SERVICES, INC. NPI is 1134367378. The provider is registered as an organization entity type.

The provider's business location address is:

1640 POWERS FERRY RD SE
BLDG. 17, STE. 350
MARIETTA, GA
ZIP 30067-491
Phone: (770) 956-9212
Fax: (770) 956-9211

The provider's authorized official is Susan Leslie Mayo .
The authorized official title is President and has the following contact phone number (770) 956-9212.

The enumeration date for this NPI number is 1/26/2009 and was last updated on 5/28/2013.


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
1251S00000XCommunity/Behavioral Health1582GEORGIANo
2103TC0700XPsychologistClinical1582GEORGIAYes

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
168BBFBCMEDICARE 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: 4/28/2024

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