| Peachtree Family Psychiatry Clinic | |
|
1720 Peachtree St Nw Ste 320 Atlanta GA 30309-2447 | |
| (404) 249-8496 | |
| Not Available |
| Full Name | Peachtree Family Psychiatry Clinic |
|---|---|
| Speciality | Psychologist |
| Location | 1720 Peachtree St Nw Ste 320, Atlanta, Georgia |
| Authorized Official Name and Position | Yassar Kanawati (PSYCHIATRIST) |
| Authorized Official Contact | 7703800635 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peachtree Family Psychiatry Clinic 1776 Peachtree St Nw Suite 310 North Atlanta GA 30309-2307 Ph: (404) 249-8496 | Peachtree Family Psychiatry Clinic 1720 Peachtree St Nw Ste 320 Atlanta GA 30309-2447 Ph: (404) 249-8496 |
| NPI Number | 1487059564 |
|---|---|
| Provider Enumeration Date | 10/30/2014 |
| Last Update Date | 06/26/2024 |
| Certification Date | 06/26/2024 |
| Medicare PECOS PAC ID | 4284957952 |
|---|---|
| Medicare Enrollment ID | O20150105000810 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487059564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 49237 (Georgia) | Primary |
| Provider Name | Yassar J Kanawati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396833638 PECOS PAC ID: 3870558398 Enrollment ID: I20041124000074 |
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