1447557913 NPI number — VETERANS PSYCHOLOGICAL GROUP, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447557913 NPI number — VETERANS PSYCHOLOGICAL GROUP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VETERANS PSYCHOLOGICAL GROUP, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447557913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
950 DANNON VW SW
Provider Second Line Business Mailing Address:
SUITE 4201
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30331-2160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-852-9020
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3915 CASCADE RD SW
Provider Second Line Business Practice Location Address:
SUITET135
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30331-8512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-852-9020
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
ELAHEE
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
MITCHUM
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
404-852-9020

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  2538 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com