Provider Demographics
NPI:1942494711
Name:RINEY, C. TIMOTHY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:C.
Middle Name:TIMOTHY
Last Name:RINEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 INDIAN TRAIL RD
Mailing Address - Street 2:STE 140
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-2627
Mailing Address - Country:US
Mailing Address - Phone:404-422-7400
Mailing Address - Fax:
Practice Address - Street 1:1770 INDIAN TRAIL RD
Practice Address - Street 2:STE 140
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-2627
Practice Address - Country:US
Practice Address - Phone:404-422-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003119103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical