Provider Demographics
NPI:1811406069
Name:TURNING LEAF PSYCHOLOGY SERVICES
Entity Type:Organization
Organization Name:TURNING LEAF PSYCHOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCGRADY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:706-347-4861
Mailing Address - Street 1:1121 CAREYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30642-3384
Mailing Address - Country:US
Mailing Address - Phone:706-347-4861
Mailing Address - Fax:860-812-2142
Practice Address - Street 1:1121 CAREYWOOD ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-3384
Practice Address - Country:US
Practice Address - Phone:706-347-4861
Practice Address - Fax:860-812-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001954103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty