Provider Demographics
NPI:1679039739
Name:PEIFER, JANELLE SUMMERVILLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:SUMMERVILLE
Last Name:PEIFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:JANELLE
Other - Middle Name:SUZANNE
Other - Last Name:SUMMERVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:229 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1038
Mailing Address - Country:US
Mailing Address - Phone:540-846-0932
Mailing Address - Fax:
Practice Address - Street 1:209B SWANTON WAY STE 204
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3271
Practice Address - Country:US
Practice Address - Phone:678-561-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004269103TB0200X, 103TC0700X, 103TF0000X, 103TP2701X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy