Provider Demographics
NPI:1023586773
Name:THE ATLANTA PSYCHOLOGY GROUP
Entity type:Organization
Organization Name:THE ATLANTA PSYCHOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-875-2050
Mailing Address - Street 1:3500 PIEDMONT RD NE STE 740
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1507
Mailing Address - Country:US
Mailing Address - Phone:404-875-2050
Mailing Address - Fax:404-875-0470
Practice Address - Street 1:3500 PIEDMONT RD NE STE 740
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1507
Practice Address - Country:US
Practice Address - Phone:404-875-2050
Practice Address - Fax:404-875-0470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-09
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty