Provider Demographics
NPI:1881014801
Name:NORTH ATLANTA NEUROPSYCHOLOGY, LLC
Entity Type:Organization
Organization Name:NORTH ATLANTA NEUROPSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:470-297-5114
Mailing Address - Street 1:1134 SATELLITE BLVD NW
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4370
Mailing Address - Country:US
Mailing Address - Phone:678-878-3559
Mailing Address - Fax:678-878-3556
Practice Address - Street 1:1134 SATELLITE BLVD NW
Practice Address - Street 2:SUITE 100A
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4370
Practice Address - Country:US
Practice Address - Phone:678-878-3559
Practice Address - Fax:678-878-3556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003287103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty