Provider Type Icon

SOUTHERN CRESCENT PHYSICIANS GROUP NPI 1801979174


NPI Information

NPI: 1801979174
Provider Name: SOUTHERN CRESCENT PHYSICIANS GROUP
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

CLIA Number: 11D0704477

Address:
11 UPPER RIVERDALE RD SW
RIVERDALE, GA
ZIP 30274
Phone: (770) 991-8500
Get Directions

SOUTHERN CRESCENT PHYSICIANS GROUP is a psychiatry psychiatry neurology in Riverdale, GA. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. SOUTHERN CRESCENT PHYSICIANS GROUP NPI is 1801979174. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11 UPPER RIVERDALE RD SW
RIVERDALE, GA
ZIP 30274-615
Phone: (770) 991-8500
Fax: (770) 991-8507

The provider's authorized official is John Mclain .
The authorized official title is Coo and has the following contact phone number (770) 991-8000.

The CLIA number assigned to this NPI record is 11D0704477 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 5/13/2015.


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
12084P0800XPsychiatry & NeurologyPsychiatry031442GEORGIAYes

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
1GRP1598MEDICARE 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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.