Provider Demographics
NPI:1790993814
Name:KATE AVINGER PSY.D., P.C.
Entity Type:Organization
Organization Name:KATE AVINGER PSY.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:AVINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:706-546-8440
Mailing Address - Street 1:485 HUNTINGTON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-1845
Mailing Address - Country:US
Mailing Address - Phone:706-546-8440
Mailing Address - Fax:706-546-8456
Practice Address - Street 1:485 HUNTINGTON RD STE 201
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-1845
Practice Address - Country:US
Practice Address - Phone:706-546-8440
Practice Address - Fax:706-546-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003056103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1225193592OtherTYPE I (INDIVIDUAL) NPI
GA1225193592OtherTYPE I (INDIVIDUAL) NPI