| United Psychology Center, Llc | |
|
2900 Chamblee Tucker Rd Bldg 16 Atlanta GA 30341-4148 | |
| (770) 939-1288 | |
| (770) 212-2203 |
| Full Name | United Psychology Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2900 Chamblee Tucker Rd Bldg 16, Atlanta, Georgia |
| Authorized Official Name and Position | Linda Lue (BUSINESS OWNER) |
| Authorized Official Contact | 7709391288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| United Psychology Center, Llc 2900 Chamblee Tucker Rd Bldg 16 Atlanta GA 30341-4148 Ph: (770) 939-1288 | United Psychology Center, Llc 2900 Chamblee Tucker Rd Bldg 16 Atlanta GA 30341-4148 Ph: (770) 939-1288 |
| NPI Number | 1063704542 |
|---|---|
| Provider Enumeration Date | 05/03/2011 |
| Last Update Date | 10/22/2020 |
| Certification Date | 10/22/2020 |
| Medicare PECOS PAC ID | 0648424796 |
|---|---|
| Medicare Enrollment ID | O20130125000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063704542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Dewitt C Alfred |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659313955 PECOS PAC ID: 7618863911 Enrollment ID: I20040415000139 |
| Provider Name | Douglas K Laipple |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659468668 PECOS PAC ID: 0547220998 Enrollment ID: I20041012000299 |
| Provider Name | Michael A Burke |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376649962 PECOS PAC ID: 7012933237 Enrollment ID: I20051020000396 |
| Provider Name | Consuelo M Reddick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437214350 PECOS PAC ID: 3173625563 Enrollment ID: I20070305000340 |
| Provider Name | William E Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871567693 PECOS PAC ID: 6608970645 Enrollment ID: I20070330000139 |
| Provider Name | D Christopher Christopher Lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982879490 PECOS PAC ID: 7416027537 Enrollment ID: I20080602000508 |
| Provider Name | Henriette Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679683924 PECOS PAC ID: 8224108089 Enrollment ID: I20080605000198 |
| Provider Name | Pamela C Mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548455454 PECOS PAC ID: 9739360025 Enrollment ID: I20110218000785 |
| Provider Name | Geri G Richardson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487855870 PECOS PAC ID: 5597940874 Enrollment ID: I20110502000381 |
| Provider Name | Tameka Harris-james |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043508351 PECOS PAC ID: 8022264936 Enrollment ID: I20120808000911 |
| Provider Name | Tiffany G Tate |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144248188 PECOS PAC ID: 3971594425 Enrollment ID: I20130925000736 |
| Provider Name | Angeletta M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447687512 PECOS PAC ID: 5698098929 Enrollment ID: I20141217002744 |
| Provider Name | Millicent L Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407994940 PECOS PAC ID: 3971541913 Enrollment ID: I20141219000694 |
| Provider Name | Courtney Fields Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356758155 PECOS PAC ID: 9436473717 Enrollment ID: I20150114001311 |
| Provider Name | Catherine L Hoover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376893131 PECOS PAC ID: 3476855842 Enrollment ID: I20160104000162 |
| Provider Name | Jenise Mitchell-harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881954527 PECOS PAC ID: 4183928971 Enrollment ID: I20160216000629 |
| Provider Name | Jamie Elizabeth Edmunds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689057218 PECOS PAC ID: 1456658384 Enrollment ID: I20160321001558 |
| Provider Name | Brian Edward Barczak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104009398 PECOS PAC ID: 1052589421 Enrollment ID: I20160921002145 |
| Provider Name | Joshua M Hatcher-mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407398142 PECOS PAC ID: 3173803756 Enrollment ID: I20161219000821 |
| Provider Name | Chandra Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497294102 PECOS PAC ID: 5193000602 Enrollment ID: I20170324001191 |
| Provider Name | Danielle Ibelema |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326331042 PECOS PAC ID: 9537480637 Enrollment ID: I20170329001150 |
| Provider Name | Haley Blair Kemp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992244354 PECOS PAC ID: 9638455876 Enrollment ID: I20170424001643 |
| Provider Name | Carajean Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205216405 PECOS PAC ID: 6305158346 Enrollment ID: I20170918001508 |
| Provider Name | Jeannine Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467961623 PECOS PAC ID: 9739448465 Enrollment ID: I20180125001284 |
| Provider Name | Terri M Clack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487169173 PECOS PAC ID: 0143579086 Enrollment ID: I20180825000126 |
| Provider Name | Germaine Langira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497256747 PECOS PAC ID: 1557614005 Enrollment ID: I20181030001875 |
| Provider Name | Holly Hollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063996577 PECOS PAC ID: 5092050633 Enrollment ID: I20181229000034 |
| Provider Name | Lee M Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710390109 PECOS PAC ID: 3577780527 Enrollment ID: I20190730001865 |
| Provider Name | Vandeler N Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609383967 PECOS PAC ID: 5294082665 Enrollment ID: I20200330003508 |
| Provider Name | Sandra Ann Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497302046 PECOS PAC ID: 5698104370 Enrollment ID: I20200331003270 |
| Provider Name | Anna Carolina Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649767310 PECOS PAC ID: 2961738497 Enrollment ID: I20200828001244 |
| Provider Name | Valeria Serban |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306942933 PECOS PAC ID: 8426153974 Enrollment ID: I20210907001314 |
| Provider Name | Kimberly Shron Stegall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710583810 PECOS PAC ID: 7315343415 Enrollment ID: I20210914002760 |
| Provider Name | Brannon Melissa Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033781174 PECOS PAC ID: 2264821446 Enrollment ID: I20211109001418 |
| Provider Name | Elizabeth Ciara Hortman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699541722 PECOS PAC ID: 3476902545 Enrollment ID: I20231214001587 |
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