Provider Demographics
NPI:1164070348
Name:WHATSON PSYCHOLOGY, LLC
Entity Type:Organization
Organization Name:WHATSON PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:WHATSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:651-341-4838
Mailing Address - Street 1:3633 WHEELER RD STE 110
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6544
Mailing Address - Country:US
Mailing Address - Phone:706-855-7784
Mailing Address - Fax:706-651-1090
Practice Address - Street 1:3633 WHEELER RD STE 110
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6544
Practice Address - Country:US
Practice Address - Phone:706-855-7784
Practice Address - Fax:706-651-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty