Provider Demographics
NPI:1821495987
Name:BYERS PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:BYERS PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:DILLON
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-378-0441
Mailing Address - Street 1:315 W PONCE DE LEON AVE
Mailing Address - Street 2:SUITE 1051
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2400
Mailing Address - Country:US
Mailing Address - Phone:404-378-0441
Mailing Address - Fax:678-317-0871
Practice Address - Street 1:315 W PONCE DE LEON AVE
Practice Address - Street 2:SUITE 1051
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2400
Practice Address - Country:US
Practice Address - Phone:404-378-0441
Practice Address - Fax:678-317-0871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003860103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1285069179OtherINDIVIDUAL NPI