# ATHENS PSYCHOLOGICAL SERVICES, LLC

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

## Provider details

- **NPI number:** 1457627044
- **Authorized official:** MR. JOSEPH E. MASON (CEO)
- **Authorized official phone:** (706) 548-8697

## Contact information

- **Practice address:** 1090 FOUNDERS BLVD, STE. B, ATHENS, GA 30606-6163
- **Practice address phone:** (706) 548-8697
- **Practice address fax:** (706) 548-8698
- **Mailing address:** 1090 FOUNDERS BLVD, STE. B, ATHENS, GA 30606-6163
- **Mailing address phone:** (706) 548-8697
- **Mailing address fax:** (706) 548-8698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | PSY002674 | GA | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | PSY002674 | GA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | PSY002674 | GA | Yes |

## Other

- **Enumeration date:** 03/28/2012
- **Last updated:** 03/28/2012