Organization
CHL PSYCHOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLINE LEAVITT PH.D. (LICENSED PSYCHOLOGIST)
(770) 592-0150
Entity
Organization
Contact information
Practice address
1001 WEATHERSTONE PKWY, SUITE 430, WOODSTOCK, GA 30188-4495
(770) 592-0150
(770) 592-0971
Mailing address
1001 WEATHERSTONE PKWY, SUITE 430, WOODSTOCK, GA 30188-4495
(770) 592-0150
(770) 592-0971
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY003317
GA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
PSY003317
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502314641A
—
GA
Enumeration date
12/03/2013
Last updated
12/03/2013
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