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Organization

ONWARD AND OUTWARD PSYCHOTHERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JANELLE SUMMERVILLE PEIFER PHD (OWNER AND CHIEF PSYCHOLOGIST)
(540) 846-0932
Entity
Organization

Contact information

Practice address
209B SWANTON WAY STE 204, DECATUR, GA 30030-3271
(678) 561-4187
Mailing address
229 WOODVIEW DR, DECATUR, GA 30030-1038
(540) 846-0932

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
103TF0000X
Family Psychologist
103TP2701X
Group Psychotherapy Psychologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6887032
AETNA
GA
01
833475697
ANTHEM
GA
Enumeration date
08/22/2019
Last updated
08/22/2019
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