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SWEETWATER PSYCHOLOGICAL ASSOCIATES LLC NPI 1467562827


NPI Information

NPI: 1467562827
Provider Name: SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
560 THORNTON RD
SUITE 106
LITHIA SPRINGS, GA
ZIP 30122
Phone: (770) 732-0982
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SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC is a clinical psychologist in Lithia Springs, GA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC NPI is 1467562827. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

560 THORNTON RD
SUITE 106
LITHIA SPRINGS, GA
ZIP 30122-655
Phone: (770) 732-0982
Fax: (770) 732-1283

The provider's authorized official is David C Martin .
The authorized official title is Owner Partner and has the following contact phone number (770) 732-0982.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 10/27/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103T00000XPsychologistPSY001373, PSY001157GEORGIANo
2103TB0200XPsychologistCognitive & BehavioralPSY001373GEORGIANo
3103TB0200XPsychologistCognitive & BehavioralPSY001157GEORGIANo
4103TC2200XPsychologistClinical Child & AdolescentPSY001373, PSY001157GEORGIANo
51041C0700XSocial WorkerClinicalCSW000729GEORGIANo
6103TC0700XPsychologistClinicalPSY001373,PSY001157GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP2778MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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