Provider Demographics
NPI:1003078569
Name:NANCY GUP AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:NANCY GUP AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:GUP
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:404-634-0014
Mailing Address - Street 1:2885 PAYTON RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2600
Mailing Address - Country:US
Mailing Address - Phone:404-634-0014
Mailing Address - Fax:404-728-0043
Practice Address - Street 1:2885 PAYTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2600
Practice Address - Country:US
Practice Address - Phone:404-634-0014
Practice Address - Fax:404-728-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2414103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty