| Jason A. King, Ph.d., Llc | |
|
1775 The Exchange Se Suite 327 Atlanta GA 30339-2016 | |
| (770) 933-4130 | |
| (770) 933-4135 |
| Full Name | Jason A. King, Ph.d., Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1775 The Exchange Se, Atlanta, Georgia |
| Authorized Official Name and Position | Jason King (MANAGING MEMBER) |
| Authorized Official Contact | 7709334130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason A. King, Ph.d., Llc 1775 The Exchange Se Suite 327 Atlanta GA 30339-2016 Ph: (770) 933-4130 | Jason A. King, Ph.d., Llc 1775 The Exchange Se Suite 327 Atlanta GA 30339-2016 Ph: (770) 933-4130 |
| NPI Number | 1700980224 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1153338850 |
|---|---|
| Medicare Enrollment ID | O20060321000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700980224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY002888 (Georgia) | Primary |
| Provider Name | Jason A King |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215157169 PECOS PAC ID: 9234150319 Enrollment ID: I20051219000261 |
| Provider Name | Catherine H Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174707756 PECOS PAC ID: 6305924507 Enrollment ID: I20080428000559 |
| Provider Name | Miriam Shapiro |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1861877292 PECOS PAC ID: 6204121080 Enrollment ID: I20160817002857 |
| Provider Name | Sabrina Hickle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205500535 PECOS PAC ID: 5890193767 Enrollment ID: I20211006002579 |
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