Organization
PSYCHIATRIC PROFESSIONALS OF GEORGIA, LLC
Active
Organization
PSYCHIATRIC PROFESSIONALS OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALEY DAVIS (PROVIDER ENROLLMENT ASSOCIATE)
(470) 857-4412
Entity
Organization
Contact information
Practice address
1325 SATELLITE BLVD NW BLDG 400, SUWANEE, GA 30024-4651
(678) 263-3080
(678) 496-9863
Mailing address
1325 SATELLITE BLVD NW BLDG 400, SUWANEE, GA 30024-4651
(678) 263-3080
(678) 496-9863
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
58297
GA
2084P0800X
Psychiatry Physician
Primary
55563
GA
2084P0804X
Child & Adolescent Psychiatry Physician
060325
GA
2084P0804X
Child & Adolescent Psychiatry Physician
59016
GA
Other
Enumeration date
04/01/2017
Last updated
07/17/2026
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