Provider Demographics
NPI:1518478023
Name:CLEARY, CATHLEEN ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:ANN
Last Name:CLEARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 PHOENIX BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349
Mailing Address - Country:US
Mailing Address - Phone:404-507-7100
Mailing Address - Fax:
Practice Address - Street 1:106 JULEE EMILYN DRIVE
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005
Practice Address - Country:US
Practice Address - Phone:404-906-6140
Practice Address - Fax:478-922-6122
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA500962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry