Provider Demographics
NPI:1477976173
Name:RHEA GORDON PHD LLC
Entity Type:Organization
Organization Name:RHEA GORDON PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-378-9444
Mailing Address - Street 1:1439 MCLENDON DRIVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1841
Mailing Address - Country:US
Mailing Address - Phone:404-378-9444
Mailing Address - Fax:404-378-9499
Practice Address - Street 1:1439 MCLENDON DRIVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-1841
Practice Address - Country:US
Practice Address - Phone:404-378-9444
Practice Address - Fax:404-378-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1448103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty