Provider Demographics
NPI:1740893601
Name:GEORGIA MOUNTAIN PSYCHOLOGICAL ASSOCIATES INC.
Entity type:Organization
Organization Name:GEORGIA MOUNTAIN PSYCHOLOGICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PILESKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:706-782-1237
Mailing Address - Street 1:851 HIGHWAY 441 S STE 105
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-5424
Mailing Address - Country:US
Mailing Address - Phone:706-782-1237
Mailing Address - Fax:404-393-0737
Practice Address - Street 1:851 HIGHWAY 441 S STE 105
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-5424
Practice Address - Country:US
Practice Address - Phone:706-782-1237
Practice Address - Fax:404-393-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty