Provider Demographics
NPI:1952958522
Name:ATLAS PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:ATLAS PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:BIPIN
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, JD
Authorized Official - Phone:404-500-9681
Mailing Address - Street 1:1100 SPRING ST NW STE 380
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2854
Mailing Address - Country:US
Mailing Address - Phone:404-500-9681
Mailing Address - Fax:404-585-5680
Practice Address - Street 1:1100 SPRING ST NW STE 380
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2854
Practice Address - Country:US
Practice Address - Phone:404-500-9681
Practice Address - Fax:404-585-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty