Organization
NORTHSIDE PSYCHOLOGICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY REDMAN (CIO)
(678) 367-7515
Entity
Organization
Contact information
Practice address
5755 N POINT PKWY, SUITE 256, ALPHARETTA, GA 30022-1142
(770) 667-3877
(770) 667-3879
Mailing address
PO BOX 250, ALPHARETTA, GA 30009-0250
(770) 667-3877
(770) 667-3879
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087076125B
—
GA
05
—
087076125C
—
GA
05
—
344168437A
—
GA
Enumeration date
12/27/2006
Last updated
10/21/2011
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