Provider Demographics
NPI:1780043976
Name:ARLEN VERSTEEG PHD PC
Entity Type:Organization
Organization Name:ARLEN VERSTEEG PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERSTEEG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-653-0322
Mailing Address - Street 1:340 BOULEVARD NE
Mailing Address - Street 2:STE 345
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1273
Mailing Address - Country:US
Mailing Address - Phone:404-653-0322
Mailing Address - Fax:404-653-0466
Practice Address - Street 1:340 BOULEVARD NE
Practice Address - Street 2:STE 345
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1273
Practice Address - Country:US
Practice Address - Phone:404-653-0322
Practice Address - Fax:404-653-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002172103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA527881OtherWELLCARE OF GA
GAGAMPBHP10000796173OtherAMBETTER
GA1348078OtherCIGNA
GAGABH101949OtherCENPATICO
GA000755334BMedicaid
GA68BBFJJMedicare PIN