Organization
PAUL W SCHENK PSYD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL W. SCHENK PSY.D. (PRESIDENT)
(770) 939-4473
Entity
Organization
Contact information
Practice address
3589 HABERSHAM AT NORTHLAKE, TUCKER, GA 30084-4009
(770) 939-4473
(770) 939-0033
Mailing address
3589 HABERSHAM AT NORTHLAKE, TUCKER, GA 30084-4009
(770) 939-4473
(770) 939-0033
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
663
GA
103TC0700X
Clinical Psychologist
Primary
663
GA
103TC2200X
Clinical Child & Adolescent Psychologist
663
GA
103TF0000X
Family Psychologist
663
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000187954A
—
GA
Enumeration date
05/23/2007
Last updated
11/16/2011
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