| Insight Psychological Solutions Llc | |
|
12461 Veterans Memorial Hwy Ste 794 Douglasville GA 30134-2025 | |
| (404) 854-4427 | |
| Not Available |
| Full Name | Insight Psychological Solutions Llc |
|---|---|
| Speciality | Psychologist |
| Location | 12461 Veterans Memorial Hwy Ste 794, Douglasville, Georgia |
| Authorized Official Name and Position | Samantha Renee Jordan (OWNER) |
| Authorized Official Contact | 4048544427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Insight Psychological Solutions Llc 12461 Veterans Memorial Hwy Ste 794 Douglasville GA 30134-2025 Ph: (404) 854-4427 | Insight Psychological Solutions Llc 12461 Veterans Memorial Hwy Ste 794 Douglasville GA 30134-2025 Ph: (404) 854-4427 |
| NPI Number | 1154021350 |
|---|---|
| Provider Enumeration Date | 03/06/2023 |
| Last Update Date | 03/06/2023 |
| Certification Date | 03/06/2023 |
| Medicare PECOS PAC ID | 9436523917 |
|---|---|
| Medicare Enrollment ID | O20230323002883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154021350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Samantha R Jordan |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1366786527 PECOS PAC ID: 0244556975 Enrollment ID: I20150224000696 |
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