DR. SUSAN KAYE BLANK (NPI# 1639112584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639112584 |
| Entity Type | Individual |
| Full Name | DR. SUSAN KAYE BLANK |
| Credential | MD |
| Practice Address |
1846 Old Norcross Rd Suite 100 Lawrenceville GA 30044-8801 |
| Practice Telephone | 7706969862 |
| Practice Fax Number | 7707100243 |
| Mailing Telephone | 7706969862 |
| Mailing Fax Number | 7707100243 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2012-09-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
033782 | GA | Allopathic & Osteopathic Physicians |
| N | 2084P2900X |
Psychiatry & Neurology Specialization: Pain Medicine |
033782 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316155047 | Susan K Blank | Internal Medicine | 924 Rugby Rd, Charlottesville, VA 22903-1606 | 2007-05-18 |
| 1841319662 | Susan G. Blank | Psychiatry & Neurology | 45 Brant Ave, Suite 2, Clark, NJ 07066-1562 | 2007-03-29 |
| 1558767442 | Susan Blank | Counselor | 755 Mount Vernon Hwy Ne, Ste 330, Atlanta, GA 30328-4274 | 2014-11-05 |
| 1255376380 | Susan Blank | Pediatrics | 303 Ninth Avenue, 3rd Floor, New York, NY 10001 | 2006-06-20 |
| Street Address |
1846 OLD NORCROSS RD SUITE 100 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30044-8801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730618265 | Balanced Life Health Care Solutions LLC | Nurse Practitioner | 1846 Old Norcross Rd, Lawrenceville, GA 30044-8801 | 2017-06-08 |
| 1164772984 | Addiction Healing Center, LLC | Clinic/Center | 1846 Old Norcross Rd, Suite 100, Lawrenceville, GA 30044-8801 | 2012-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740811892 | Berry and Mitchell Hands of Caring | Nurse's Aide | 1180 Market Square Lane, Lawrenceville, GA 30044 | 2020-01-28 |
| 1457995045 | Reagan Urgent Care | Clinic/Center | 2878 Five Forks Trickum Rd Ste 2a, Lawrenceville, GA 30044 | 2019-11-06 |
| 1194373621 | Kaseem Beck | Dentist | Gwinnett Family Dental Care, 3455 Lawrenceville Hwy, Lawrenceville, GA 30044 | 2019-08-28 |
| 1053965525 | Imani Anderson | Speech-Language Pathologist | 2775 Cruse Rd Suite 2002, Lawrenceville, GA 30044 | 2019-08-01 |
| 1598329625 | Zam Zam Family Clinic LLC | Clinic/Center | 965 Oakland Road, Bldg 3 Ste D & E, Lawrenceville, GA 30044 | 2019-04-24 |
| 1659858991 | Apex Eyecare | Optometrist | 3694 Club Drive Unit 101, Lawrenceville, GA 30044 | 2018-07-19 |
| 1538657549 | Georgia Comprehensive Family Clinic & Natural Health | Naturopath | 1065 Pleasant Hill Rd, Lawrenceville, GA 30044 | 2018-04-25 |
| 1316434095 | Children's Dentistry of Lithonia, LLC | Dentist | 4850 Sugarloaf Parkway, Ste 611, Lawrenceville, GA 30044 | 2018-04-18 |
| 1831619337 | Legacy Healthcare Services, Inc. | Occupational Therapist | 2899 Five Forks Trickum Rd Apt 204, Lawrenceville, GA 30044 | 2017-06-26 |
| 1326582859 | Ana Coronado | Social Worker | 965 Oakland Road Nw, Suite 3b, Lawrenceville, GA 30044 | 2016-12-19 |
| Find all providers in zip 30044 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598032682 | Kambiz Aflatoon | Psychiatry & Neurology | 250 Scenic Hwy, Lawrenceville, GA 30046-5675 | 2011-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821393380 | Tifton Addiction Associates, LLC. D/b/a Tlc Clinic | Psychiatry & Neurology | 2402 North Tift Ave Suite 202, Tifton, GA 31794 | 2011-01-14 |
| 1578754503 | Omobolaji Oluseyi Oyebanjo Popoola | Psychiatry & Neurology | 307 Old Stone Rd, Villa Rica, GA 30180-1214 | 2007-08-06 |
| 1760517254 | Todd Estroff | Psychiatry & Neurology | 627 Old Ivy Rd Ne, Atlanta, GA 30342-4319 | 2007-02-23 |
| 1861534802 | Joseph Francis Griffin IIi | Psychiatry & Neurology | 1677 East Clifton Rd, Atlanta, GA 30307-1289 | 2007-02-13 |
| 1346253309 | John L Moseri | Psychiatry & Neurology | 4540 Glenwood Rd, Decatur, GA 30032-5166 | 2006-08-14 |
| 1710997069 | Ayman Mohsen Fareed | Psychiatry & Neurology | 330 Mount Sinai Dr, Dahlonega, GA 30533-2367 | 2006-08-09 |
| 1194716282 | Ramachandra R Paidi | Psychiatry & Neurology | 106 Queen St, Suite 1a, Vidalia, GA 30474-4210 | 2005-10-29 |
| 1396389185 | Keystone Psychiatric Care LLC | Psychiatry & Neurology | 11030 Jones Bridge Rd Ste 301, Johns Creek, GA 30022-4560 | 2019-11-05 |
| 1841672789 | Joseph Emmanuel Mathias | Psychiatry & Neurology | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2015-06-28 |
| 1093067084 | Kambiz Aflatoon Do | Psychiatry & Neurology | 2150 Peachford Rd, Suite A, Atlanta, GA 30338-6520 | 2012-10-15 |
| Find all providers with the same taxonomy | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30044 |
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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.