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PSYCHOLOGICAL AFFILIATES NPI 1376728394


NPI Information

NPI: 1376728394
Provider Name: PSYCHOLOGICAL AFFILIATES
Classification: Psychologist - 103T00000X
Entity Type: Organization
Address:
122 CHERRY ST NE
MARIETTA, GA
ZIP 30060
Phone: (770) 427-2911
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PSYCHOLOGICAL AFFILIATES is a psychologist in Marietta, GA. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. PSYCHOLOGICAL AFFILIATES NPI is 1376728394. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

122 CHERRY ST NE
MARIETTA, GA
ZIP 30060-206
Phone: (770) 427-2911

The provider's authorized official is Jack Holland Grisham .
The authorized official title is President and has the following contact phone number (770) 427-2911.

The enumeration date for this NPI number is 1/9/2008 and was last updated on 1/9/2008.


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
11041C0700XSocial WorkerClinical001135 GAGEORGIANo
21041C0700XSocial WorkerClinicalGA CSW003681GEORGIANo
3103T00000XPsychologist000669 GAGEORGIAYes

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
180BBGBZMEDICARE PINGEORGIA
280BBGNQMEDICARE PINGEORGIA

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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