Provider Demographics
NPI:1851324842
Name:PSYCHOLOGICAL TESTING & COUNSELING INC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL TESTING & COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:SUE SNYDER
Authorized Official - Last Name:DENOIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-777-8231
Mailing Address - Street 1:3930 THREE CHIMNEYS LN
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6998
Mailing Address - Country:US
Mailing Address - Phone:770-777-2831
Mailing Address - Fax:770-777-2832
Practice Address - Street 1:2050 MARCONI DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5201
Practice Address - Country:US
Practice Address - Phone:770-777-2831
Practice Address - Fax:770-777-2832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY002613103G00000X
GAPSY002613103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000980581AMedicaid
GA000980581AMedicaid