Samudra Psychological Services Llc | |
675 Seminole Ave Ne Ste T03 Atlanta GA 30307-3409 | |
(404) 249-0520 | |
Not Available |
Full Name | Samudra Psychological Services Llc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 675 Seminole Ave Ne Ste T03, Atlanta, Georgia |
Authorized Official Name and Position | Elizabeth Sue Bradshaw-livingston (LICENSED PSYCHOLOGIST) |
Authorized Official Contact | 4042490520 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Samudra Psychological Services Llc 316 Somerlane Pl Avondale Estates GA 30002-1221 Ph: (269) 352-7407 | Samudra Psychological Services Llc 675 Seminole Ave Ne Ste T03 Atlanta GA 30307-3409 Ph: (404) 249-0520 |
NPI Number | 1194202911 |
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Provider Enumeration Date | 07/24/2018 |
Last Update Date | 07/24/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194202911 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 003691 (Georgia) | Primary |
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