Provider Demographics
NPI:1508679697
Name:GEORGIA PSYCHIATRY & SLEEP
Entity type:Organization
Organization Name:GEORGIA PSYCHIATRY & SLEEP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HAPPY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-833-6885
Mailing Address - Street 1:1314 CONCORD RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4361
Mailing Address - Country:US
Mailing Address - Phone:770-438-1799
Mailing Address - Fax:
Practice Address - Street 1:1 BALTIMORE PL NW STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2114
Practice Address - Country:US
Practice Address - Phone:470-737-1606
Practice Address - Fax:833-973-4256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEORGIA PSYCHIATRY AND SLEEP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA51965OtherGEORGIA MEDICAL LICENSE