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Contact Information

PEACHTREE PEDIATRIC PSYCHOLOGY, LLC
750 HAMMOND DRIVE
BLDG 7, STE 200
ATLANTA, GA30328
 Phone: 404-796-7777
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PEACHTREE PEDIATRIC PSYCHOLOGY, LLC

NPI # 1861998585
LBN Legal business name PEACHTREE PEDIATRIC PSYCHOLOGY, LLC
Authorized official AVITAL COHEN - (LICENSED PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 04/02/2018
Last updated 04/02/2018 - About 8 years ago
Identifiers
GA License # 3672
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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