| Powell Psychological Associates | |
|
2501 E Piedmont Rd Suite 200, Pmb 5 Marietta GA 30062-7752 | |
| (404) 403-6177 | |
| (404) 393-6460 |
| Full Name | Powell Psychological Associates |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2501 E Piedmont Rd, Marietta, Georgia |
| Authorized Official Name and Position | James Powell (OWNER) |
| Authorized Official Contact | 4044036177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Powell Psychological Associates 2501 E Piedmont Rd Suite 200, Pmb 5 Marietta GA 30062-7752 Ph: (404) 403-6177 | Powell Psychological Associates 2501 E Piedmont Rd Suite 200, Pmb 5 Marietta GA 30062-7752 Ph: (404) 403-6177 |
| NPI Number | 1003169145 |
|---|---|
| Provider Enumeration Date | 10/25/2012 |
| Last Update Date | 10/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003169145 | NPI | - | NPPES |
| 000480686A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY002212 (Georgia) | Primary |
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