# NORTHSIDE PSYCHOLOGICAL SERVICES, INC.

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

## Provider details

- **NPI number:** 1568527505
- **Authorized official:** EMILY REDMAN (CIO)
- **Authorized official phone:** (678) 367-7515

## Contact information

- **Practice address:** 5755 N POINT PKWY, SUITE 256, ALPHARETTA, GA 30022-1142
- **Practice address phone:** (770) 667-3877
- **Practice address fax:** (770) 667-3879
- **Mailing address:** PO BOX 250, ALPHARETTA, GA 30009-0250
- **Mailing address phone:** (770) 667-3877
- **Mailing address fax:** (770) 667-3879

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 10/21/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 087076125B | — | GA |
| 05 | — | 087076125C | — | GA |
| 05 | — | 344168437A | — | GA |