Provider Demographics
NPI:1609010479
Name:SCHEINBERG, KELLY ALEXIS (MD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ALEXIS
Last Name:SCHEINBERG
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 1:114 SLOAN ST
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4922
Mailing Address - Country:US
Mailing Address - Phone:770-594-3099
Mailing Address - Fax:770-594-3099
Practice Address - Street 1:114 SLOAN ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-4922
Practice Address - Country:US
Practice Address - Phone:770-594-3099
Practice Address - Fax:770-594-3099
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA676082084P0800X, 2084P0802X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program