Provider Demographics
NPI:1568678373
Name:JOANNE Y. MAX, PH.D., P.C.
Entity Type:Organization
Organization Name:JOANNE Y. MAX, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAX
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-933-4130
Mailing Address - Street 1:1775 THE EXCHANGE SE
Mailing Address - Street 2:SUITE 327
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1775 THE EXCHANGE SE
Practice Address - Street 2:SUITE 327
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2016
Practice Address - Country:US
Practice Address - Phone:770-933-4130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBCKVMedicare ID - Type Unspecified