Provider Demographics
NPI:1992862213
Name:NORTH GEORGIA PSYCHOTHERAPY SERVICES LLC
Entity Type:Organization
Organization Name:NORTH GEORGIA PSYCHOTHERAPY SERVICES LLC
Other - Org Name:NGPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:SUTTON
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:770-926-0005
Mailing Address - Street 1:7450 HIGHWAY 92
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5235
Mailing Address - Country:US
Mailing Address - Phone:770-926-0005
Mailing Address - Fax:770-926-0762
Practice Address - Street 1:7450 HIGHWAY 92
Practice Address - Street 2:SUITE 110
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5235
Practice Address - Country:US
Practice Address - Phone:770-926-0005
Practice Address - Fax:770-926-0762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty