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LIVING FULLY PSYCHOLOGICAL SERVICES LLC NPI 1639439201


NPI Information

NPI: 1639439201
Provider Name: LIVING FULLY PSYCHOLOGICAL SERVICES, LLC

Other Name: PEGAH MOGHADDAM, PSY.D.

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
111 N MCDONOUGH ST
DECATUR, GA
ZIP 30030
Phone: (678) 591-9117
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LIVING FULLY PSYCHOLOGICAL SERVICES, LLC is a clinical psychologist in Decatur, 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. LIVING FULLY PSYCHOLOGICAL SERVICES, LLC NPI is 1639439201. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Pegah Moghaddam, Psy.d..

The provider's business location address is:

111 N MCDONOUGH ST
DECATUR, GA
ZIP 30030-317
Phone: (678) 591-9117
Fax: (770) 458-8640

The provider's authorized official is Pegah Moghaddam .
The authorized official title is Director and has the following contact phone number (678) 591-9117.

The enumeration date for this NPI number is 5/17/2012 and was last updated on 3/4/2013.


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
1103TC0700XPsychologistClinicalPSY003405GEORGIAYes

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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