DR. WILLIE F AUSBORN (NPI# 1366596025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366596025 |
| Entity Type | Individual |
| Full Name | DR. WILLIE F AUSBORN |
| Credential | PSY.D |
| Practice Address |
4500 Hugh Howell Rd Suite 740 Tucker GA 30084-4723 |
| Practice Telephone | 7709384616 |
| Practice Fax Number | 7709384615 |
| Mailing Telephone | 7709384616 |
| Mailing Fax Number | 7709384615 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2009-09-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2449 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AMERIGROUP | 01000298 | 01 |
| GA | KAISER | A3022 | 01 |
| GA | 000885629A | 05 | |
| GA | BLUECROSS BLUESHIELD | 001346 | 01 |
| GA | NORTHLAKE MEDICAL RESEARC | 33-1078488 | 01 |
| GA | CENPATICO | 000885629A | 01 |
| Street Address |
4500 HUGH HOWELL RD SUITE 740 |
| City | TUCKER |
| State | GA |
| Zip Code | 30084-4723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679579643 | Steven O. Stewart | Family Medicine | 4500 Hugh Howell Rd, Ste 220, Tucker, GA 30084 | 2005-06-24 |
| 1578017703 | Julia Eze | Nurse Practitioner | 4500 Hugh Howell Rd, Suite 110, Tucker, GA 30084-4723 | 2016-08-04 |
| 1518344068 | Sunrise Medical Company LLC | Clinic/Center | 4500 Hugh Howell Rd, Suite 110, Tucker, GA 30084-4723 | 2015-05-05 |
| 1265867014 | Joo-won Kim | Dentist | 4500 Hugh Howell Rd, Suite 140, Tucker, GA 30084-4723 | 2013-09-12 |
| 1316389679 | Deirdre Bonaparte | Speech-Language Pathologist | 4500 Hugh Howell Rd, Suite 780, Tucker, GA 30084-4723 | 2013-07-26 |
| 1700226750 | Hearts and Hands Therapy Services, Inc. | Physical Therapist | 4500 Hugh Howell Rd, Suite 780, Tucker, GA 30084-4723 | 2013-07-04 |
| 1184964967 | Stewart Family Practice, PC | Family Medicine | 4500 Hugh Howell Rd, Ste 220, Tucker, GA 30084-4723 | 2013-02-15 |
| 1033497409 | Ketan G Ginoya | Dentist | 4500 Hugh Howell Rd, 140, Tucker, GA 30084-4723 | 2011-08-02 |
| 1669777157 | Accuquest Hearing Center | Clinic/Center | 4500 Hugh Howell Rd, Ste 340, Tucker, GA 30084-4723 | 2011-01-14 |
| 1518297266 | Executive Medical Associates | Internal Medicine | 4500 Hugh Howell Rd, Building 270, Suite B, Tucker, GA 30084-4723 | 2009-12-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609401355 | Excellent Medical Transport | Ambulance | 4378 Sentry Dr, Tucker, GA 30084 | 2020-03-03 |
| 1811468796 | Caleb Lee Ebbets | Physical Therapist | 1459 Montreal Road, Medical Office Building, Suite 301, Tucker, GA 30084 | 2018-12-17 |
| 1417436130 | Benjamin Han Wook Chong | Physical Therapist | 1460 Montreal Road East, Suite 300, Tucker, GA 30084 | 2018-08-13 |
| 1336659325 | Lavista Acupuncture and Herbal Medicine | Acupuncturist | 4915 Lavista Rd, Tucker, GA 30084 | 2017-10-04 |
| 1699294207 | Debrica Butler | Counselor | 1021 Oak Chase Dr., Apt C, Tucker, GA 30084 | 2017-09-14 |
| 1295264695 | Jolanta Wazgowska Hopkins | Social Worker | 4404 Idlewood Lane, Tucker, GA 30084 | 2017-06-08 |
| 1164956157 | Sage Dental Group of Georgia LLC | Dentist | 4320 Lavista Rd, Suite C119, Tucker, GA 30084 | 2017-04-17 |
| 1689107807 | Mashail Manzur | Podiatrist | 1460 Montreal Rd E, Ste 275, Tucker, GA 30084 | 2017-04-05 |
| 1053765578 | Jessica Spruyt | Speech-Language Pathologist | 3756 Lavista Rd Suite 104, Tucker, GA 30084 | 2016-04-21 |
| 1265802318 | Spine and Orthopedics of Atlanta, LLC | Clinic/Center | 1462 Montreal Rd Ste 218, Tucker, GA 30084 | 2015-10-01 |
| Find all providers in zip 30084 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811007909 | Richard W Rasche | Psychologist | 3548b Habersham At Northlake, Tucker, GA 30084-4009 | 2006-08-30 |
| 1629435540 | Catherine Reynolds | Psychologist | 1479 Brockett Rd, Suite 100, Tucker, GA 30084-7326 | 2016-01-22 |
| 1255743670 | Healthy Minds Psychology Associates Inc | Psychologist | 1479 Brockett Rd, Ste 100, Tucker, GA 30084-7326 | 2014-05-21 |
| 1508153669 | Daniel Leroy Hatch | Psychologist | 4823 N Royal Atlanta Dr, Tucker, GA 30084-3806 | 2011-07-08 |
| 1629389143 | Rebecca Eisenberg Mccartney | Psychologist | 200 Crescent Center Pkwy, Tucker, GA 30084-7047 | 2010-06-30 |
| 1720278658 | Teresa Carol Whitehurst | Psychologist | 200 Crescent Centre Parkway, Kp Crescent Centre Medical Center, Tucker, GA 30084 | 2007-07-26 |
| 1942422019 | Rasche Associates, P.C. | Psychologist | 3580 Habersham At Northlake, Tucker, GA 30084-4009 | 2007-05-02 |
| 1174676563 | Denella Lazenby Ausborn | Psychologist | 4500 Hugh Howell Rd, Suite 740, Tucker, GA 30084-4723 | 2007-01-19 |
| 1164582417 | Carolyn B Rasche | Psychologist | 3548b Habersham At Northlake, Tucker, GA 30084-4009 | 2006-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403462 | Molly Elizabeth Katherine Mclaren | Psychologist | 1441 Clifton Rd Ne Ste 170, Atlanta, GA 30322-1004 | 2020-10-07 |
| 1588261945 | Raven Evans | Psychologist | 1800 Lake Park Dr Se Ste 123, Smyrna, GA 30080-7639 | 2020-10-07 |
| 1255945572 | Kerri Eileen Woodward | Psychologist | 6000 Lake Forrest Dr Ste 103, Atlanta, GA 30328-5902 | 2020-09-03 |
| 1932721784 | Essential Counseling & Consulting, Inc | Psychologist | 2800 Old Spanish Trl, College Park, GA 30349-4266 | 2020-05-15 |
| 1689296980 | Natalie N Watson-singleton | Psychologist | 2124 Cheshire Bridge Rd Ne Apt 4112, Atlanta, GA 30324-5733 | 2020-05-11 |
| 1336760164 | Lauren Olivia Patterson | Psychologist | 209 Thornwood Ct, Statesboro, GA 30458-0296 | 2020-05-04 |
| 1972123883 | Elizabeth Newton, Psyd and Assoc Inc | Psychologist | 1827 Powers Ferry Rd, Bldg 21, Atlanta, GA 30339 | 2020-04-21 |
| 1669091989 | Juliet Anne Buchwalter | Psychologist | 49 Lenox Pointe Ne Ste A, Atlanta, GA 30324-7426 | 2020-04-16 |
| 1790319549 | Thaddeus Reecesiri Reece | Psychologist | 771 Tulip Poplar Way, Lawrenceville, GA 30044-8819 | 2020-03-02 |
| 1508498395 | Walker Consulting & Psychological Services | Psychologist | 4375 Cobb Pkwy Se Ste 121, Atlanta, GA 30339-5537 | 2020-02-10 |
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| 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.