# SOUTHEASTERN PSYCHOLOGICAL ASSOCIATES, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316216880
- **Authorized official:** DR. PRISCILLA FAULKNER PSYD (OWNER/DIRECTOR)
- **Authorized official phone:** (678) 712-6520

## Contact information

- **Practice address:** 3155 MILL STREET, COVINGTON, GA 30014
- **Practice address phone:** (404) 226-0939
- **Practice address fax:** (678) 802-0939
- **Mailing address:** 3155 MILL STREET, COVINGTON, GA 30014-2542
- **Mailing address phone:** (678) 712-6520
- **Mailing address fax:** (678) 712-6521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | PSY002144 | GA | Yes |

## Other

- **Enumeration date:** 12/29/2011
- **Last updated:** 05/03/2017