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Contact Information

COMMENCEMENT ETC PC
1300 RIDENOUR BLVD NW STE 100
KENNESAW, GA30152-4528
 Phone: 470-407-3127
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Forensic

103TF0200X 62 Psychologist, Clinical
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Health

103TH0004X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for COMMENCEMENT ETC PC

NPI Number 1215649967
LBN Legal business name COMMENCEMENT ETC PC
Authorized official SYNITA HUDGINS - (OWNER/CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/14/2022
Last updated 12/14/2022 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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