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NPI Profile for PROVIDENCE RESIDENTIAL OUTPATIENT PTSD SERVICES LLC in DOUGLASVILLE, GA.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Clinical |
103TC0700X | 62 | Psychologist, Clinical | |
Acupuncturist |
171100000X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Case Manager/Care Coordinator |
171M00000X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker | |
Counselor |
101Y00000X | |||
Dietetic Technician, Registered |
136A00000X | |||
Licensed Practical Nurse |
164W00000X | |||
Marriage & Family Therapist |
106H00000X | |||
Nutritionist |
133N00000X | |||
Professional |
101YP2500X | |||
Psychiatric/Mental Health |
163WP0808X | |||
Psychiatry |
2084P0800X | 26 | Physician/Psychiatry | |
Social Worker |
104100000X | |||
Technician |
374700000X |
| NPI Number | 1215357272 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/17/2014 | |
| Last updated | 04/17/2014 - About 12 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES, LLC
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| INGRID FANNIN, REGISTERED NURSE 3699 BAKERS FERRY RD SW ATLANTA, GA |
| JAMES L ARTIS JR, LPC 3896 PRINCETON LAKES WAY ATLANTA, GA |
| CARMEN ARDOIN 2636 MARTIN LUTHER KING JR. DRIVE ATLANTA, GA |
| SHONALI SAHA, MD 3020 HIGHLANDS PKWY SE SMYRNA, GA |
| ANNIE KATE E CHAMPAGNE 707 WHITLOCK AVE NW MARIETTA, GA |
| JEFFREY H KLOPPER, MD 3188 ATLANTA ROAD SMYRNA, GA |
| RAYMOND H STEGALL, LCSW 3188 ATLANTA ROAD SMYRNA, GA |
| GUY H SOMMERS JR, MD 4015 S COBB DR SE SMYRNA, GA |
| RACHEL FEIT, PSY.D 55 WHITCHER ST NE STE 420 MARIETTA, GA |
| STEPHANIE LEONI, LPC 4575 WEBB BRIDGE ROAD ALPHARETTA, GA |
PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES, LLC