GEORGIA AUTISM CENTER LLC NPI 1376059998

NPI Information

  • NPI: 1376059998
  • Provider Name: GEORGIA AUTISM CENTER LLC
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Doing Business As: JAYMIE HELEN LUCKOW FOX SOLE MBR
  • Address: 4046 WETHERBURN WAY STE 1
    PEACHTREE CORNERS, GA
    ZIP 30092
  • Phone: (770) 696-4384

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NPI Details

GEORGIA AUTISM CENTER LLC is a clinical psychologist in Peachtree Corners, 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. GEORGIA AUTISM CENTER LLC NPI is 1376059998. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Jaymie Helen Luckow Fox Sole Mbr.

The provider's business location address is:

4046 WETHERBURN WAY STE 1
PEACHTREE CORNERS, GA
ZIP 30092-614
Phone: (770) 696-4384

The provider's authorized official is Jaymie L Fox .
The authorized official title is Owner and has the following contact phone number (770) 696-4384.

The enumeration date for this NPI number is 12/19/2017 and was last updated on 12/19/2017.

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
1103TC0700XPsychologistClinicalPSY2999GEORGIAYes

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
1380415072CMEDICAIDGEORGIA

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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