Provider Demographics
NPI:1558516997
Name:GEORGIA PSYCHIATRY & SLEEP
Entity Type:Organization
Organization Name:GEORGIA PSYCHIATRY & SLEEP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAPPY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-833-6885
Mailing Address - Street 1:1314 CONCORD RD SE STE 220
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4361
Mailing Address - Country:US
Mailing Address - Phone:770-438-1799
Mailing Address - Fax:770-825-9046
Practice Address - Street 1:1314 CONCORD RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4361
Practice Address - Country:US
Practice Address - Phone:770-438-1799
Practice Address - Fax:770-825-9046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0601932084P0800X, 2084P0804X
2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty