Provider Demographics
NPI:1083766133
Name:SANDRA SIMS PATTERSON,PH.D.,P.C.
Entity Type:Organization
Organization Name:SANDRA SIMS PATTERSON,PH.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:SIMS
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-874-9207
Mailing Address - Street 1:600 W PEACHTREE ST NW
Mailing Address - Street 2:SUITE 1570
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-3607
Mailing Address - Country:US
Mailing Address - Phone:404-874-9207
Mailing Address - Fax:404-876-4262
Practice Address - Street 1:600 W PEACHTREE ST NW
Practice Address - Street 2:SUITE 1570
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-3607
Practice Address - Country:US
Practice Address - Phone:404-874-9207
Practice Address - Fax:404-876-4262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY000812103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty