Provider Demographics
NPI:1265534481
Name:PATE AND CULP PSYCHOLOGICAL ASSOCIATES
Entity type:Organization
Organization Name:PATE AND CULP PSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:CULP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-595-0062
Mailing Address - Street 1:2440 LAWRENCEVILLE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3226
Mailing Address - Country:US
Mailing Address - Phone:678-595-0062
Mailing Address - Fax:404-634-3482
Practice Address - Street 1:2440 LAWRENCEVILLE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3226
Practice Address - Country:US
Practice Address - Phone:678-595-0062
Practice Address - Fax:404-634-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2391103TC0700X
GA2771103TC0700X
GA2384103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4959Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER