WELLSTAR NEUROPSYCHOLOGY, LLC (NPI# 1083880744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083880744 |
| Entity Type | Organization |
| Organization Name | WELLSTAR NEUROPSYCHOLOGY, LLC |
| Practice Address |
677 Church St Ne Marietta GA 30060-1101 |
| Practice Telephone | 7707936695 |
| Practice Fax Number | 7707937997 |
| Mailing Telephone | 7707936695 |
| Mailing Fax Number | 7707937997 |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2020-02-24 |
| Authorized Official Name | MS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 7707925261 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Street Address |
677 CHURCH ST NE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841285095 | Grace S Kim | Anesthesiology | 677 Church St Ne, Marietta, GA 30060-1101 | 2005-09-14 |
| 1205436425 | Lakesha Alexis | Nurse Practitioner | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-10-27 |
| 1710594080 | Terrence Helms | Nurse Anesthetist, Certified Registered | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-09-30 |
| 1063022481 | Laura Elliott | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-08-01 |
| 1346868908 | Megan Grace Zimmerman | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-07-10 |
| 1578180535 | Devon Potler-jack | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-06-25 |
| 1740802032 | Noelle Shaw | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-05-11 |
| 1316567860 | Molly O'keeffe | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-24 |
| 1740800317 | Sara Roberts | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-23 |
| 1508486184 | Luke Bishop | Student in an Organized Health Care Education/Training Program | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003877671 | Dennis Bruce Lindenbaum | Clinical Neuropsychologist | 789 Fox Hollow Pkwy, Marietta, GA 30068-2406 | 2006-03-31 |
| 1235796319 | Brian Joseph Wilehlm | Clinical Neuropsychologist | 2855 Julias Way Nw, Marietta, GA 30064-6219 | 2019-05-23 |
| 1578049656 | Christine Ghilain | Clinical Neuropsychologist | 3939 Roswell Rd, Marietta, GA 30062-6251 | 2018-07-12 |
| 1720515042 | Stephanie L Salinas | Clinical Neuropsychologist | 3939 Roswell Rd Ste 200, Marietta, GA 30062-6285 | 2017-05-17 |
| 1427591692 | Jessica H. Robbins | Clinical Neuropsychologist | 100 Lacy St Nw Ste 150, Marietta, GA 30060-1273 | 2016-11-21 |
| 1114397585 | Kirk Bryant | Clinical Neuropsychologist | 3939 Roswell Rd Ste 200, Marietta, GA 30062-6285 | 2015-09-29 |
| 1447501069 | Jonathan Noel Dodd | Clinical Neuropsychologist | 55 Whitcher St Ne Ste 420, Marietta, GA 30060 | 2012-09-21 |
| 1285787275 | Connie Dessonville Hill | Clinical Neuropsychologist | 125 Church St Ne, Suite 210, Marietta, GA 30060-8638 | 2007-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720614746 | Neuropsychology Associates of Georgia LLC | Clinical Neuropsychologist | 280 Interstate North Cir Se Ste 450, Atlanta, GA 30339-2451 | 2020-03-21 |
| 1023586773 | The Atlanta Psychology Group | Clinical Neuropsychologist | 3500 Piedmont Rd Ne Ste 740, Atlanta, GA 30305-1507 | 2018-11-09 |
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1861998197 | Daniel B Charek | Clinical Neuropsychologist | 11685 Alpharetta Hwy Ste 170, Roswell, GA 30076 | 2018-04-04 |
| 1316451719 | Zainab Delawalla | Clinical Neuropsychologist | 125 Clairemont Ave Ste 510, Decatur, GA 30030-2504 | 2017-11-21 |
| 1588199327 | Scott Edward Miller | Clinical Neuropsychologist | 352 Milledge Hall, University of Georgia, Athens, GA 30602-5875 | 2017-05-01 |
| 1053850172 | S. Marilyn Miller | Clinical Neuropsychologist | 90 Fairlie St Nw, Suite 203, Atlanta, GA 30303-2127 | 2017-02-22 |
| 1457898371 | Tamara Weiss, M.d., LLC | Clinical Neuropsychologist | 1772 Century Blvd Ne Ste A, Atlanta, GA 30345-3396 | 2017-01-30 |
| 1689048076 | Laura Blackwell | Clinical Neuropsychologist | 5455 Meridian Marks Rd Ste 180, Atlanta, GA 30342-4716 | 2015-11-23 |
| 1003205741 | Lifespan Psychology, P.C. | Clinical Neuropsychologist | 98 Voorhees Rd E, Hamilton, GA 31811-5671 | 2015-01-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WELLSTAR NEUROPSYCHOLOGY, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.