Provider Demographics
NPI:1689813412
Name:NORTH FULTON PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:NORTH FULTON PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:COX
Authorized Official - Last Name:PURSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MS
Authorized Official - Phone:770-752-8999
Mailing Address - Street 1:41 MILTON AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-1570
Mailing Address - Country:US
Mailing Address - Phone:770-752-8999
Mailing Address - Fax:678-277-9181
Practice Address - Street 1:41 MILTON AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1570
Practice Address - Country:US
Practice Address - Phone:770-752-8999
Practice Address - Fax:678-277-9181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001879103T00000X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R-9225Medicare UPIN
GA68BBDXMMedicare UPIN