CARL TELLES CLARKE (NPI# 1881741353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881741353 |
| Entity Type | Individual |
| Full Name | CARL TELLES CLARKE |
| Other Name | CARL PRINTICE TELLES |
| Credential | PH.D. |
| Practice Address |
1834 Clairmont Rd Decatur GA 30033-3405 |
| Mailing Address |
3050 Clairmont Rd Ne Apt D Atlanta GA 30329-1622 |
| Practice Telephone | 4046680281 |
| Mailing Telephone | 4043259955 |
| Mailing Fax Number | 4047289275 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | PSY000377 | GA | Behavioral Health & Social Service Providers |
| X | 103TC0700X |
Psychologist Specialization: Clinical |
PSY000377 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | BC-BS PROVIDER ID # | 52026914 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861709495 | Carl L Clarke | Physician Assistant | 767 E 10th St, 2a, Brooklyn, NY 11230-2320 | 2010-09-02 |
| Street Address |
1834 CLAIRMONT RD |
| City | DECATUR |
| State | GA |
| Zip Code | 30033-3405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164989265 | Upasna Sharma | Nurse Practitioner | 1834 Clairmont Rd, Decatur, GA 30033-3405 | 2019-02-25 |
| 1891173498 | Ortho Sport and Spine Physicians Decatur Office | Orthopaedic Surgery | 1834 Clairmont Rd, Decatur, GA 30033 | 2015-05-14 |
| 1235573841 | Physicians Immediate Med of Decatur, P.C. | Clinic/Center | 1834 Clairmont Rd, Decatur, GA 30033-3405 | 2013-04-25 |
| 1902148752 | Adebowale O Akintayo | Family Medicine | 1834 Clairmont Rd, Decatur, GA 30033-3405 | 2013-03-20 |
| 1659598720 | Gus Bernd Kaufman Jr. | Psychologist | 1834 Clairmont Rd, Decatur, GA 30033-3405 | 2007-04-19 |
| 1962538785 | Jim Keith Harris | Social Worker | 1834 Clairmont Rd, Decatur, GA 30033-3405 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613785 | Healing Minds, Helping Hearts, LLC | Social Worker | 2532 N Decatur Rd, Apt 1304, Decatur, GA 30033 | 2020-09-09 |
| 1700412517 | Delana Finney | Orthotist | Vamc - Atlanta, 1670 Clairmont Rd, Decatur, GA 30033 | 2020-03-13 |
| 1194389353 | Katherine Serafen | Physician Assistant | 2701 N Decatur Road, Ground Floor Suite 520, Decatur, GA 30033 | 2019-04-23 |
| 1194290973 | Suzanne Johnson | Psychologist | Atlanta Va Health Care System, 1670 Clairmont Rd, Decatur, GA 30033 | 2018-10-09 |
| 1245705334 | Mcleod Counseling Services, LLC | Clinic/Center | 2801 N. Decatur Rd, Suite 185, Decatur, GA 30033 | 2018-10-04 |
| 1225514797 | Erkin Mirkhatovich Turganov | Pharmacist | 2951 Cedar Brook Dr, Decatur, GA 30033 | 2018-07-17 |
| 1356834972 | Sharlencia Lord | Nurse Practitioner | 2738 N Decatur Rd # 292-3173, Decatur, GA 30033 | 2018-06-08 |
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1437669751 | Sholanda D Hooper | Nurse Practitioner | 1601 Clairmont Rd, Decatur, GA 30033 | 2017-10-02 |
| Find all providers in zip 30033 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290973 | Suzanne Johnson | Psychologist | Atlanta Va Health Care System, 1670 Clairmont Rd, Decatur, GA 30033 | 2018-10-09 |
| 1841736535 | Anna Trad and Associates | Psychologist | 1244 Clairmont Rd Ste 204, Decatur, GA 30030-1263 | 2017-01-18 |
| 1871980383 | Tomina Jean Schwenke | Psychologist | 748 Livingston Pl, Decatur, GA 30030-3947 | 2015-04-22 |
| 1215365697 | Geraldine Oxhandler | Psychologist | 16465 Parker St, Decatur, MI 49045-9467 | 2013-10-23 |
| 1063715290 | Douglas E Webb | Psychologist | 685 Densley Dr, Decatur, GA 30033-5445 | 2010-12-09 |
| 1811227127 | Angela R Bethea | Psychologist | 315 West Ponce De Leon Avenue, Suite 350, Decatur, GA 30030-2490 | 2010-01-08 |
| 1215158993 | Carmen Lita Vargo-moncier | Psychologist | North Alabama Regional Hospital, 4218 Us Highway 31 South, Decatur, AL 35603-5039 | 2007-05-01 |
| 1861554776 | Regina Delicia Ward | Psychologist | 3553b Memorial Dr, Decatur, GA 30032-2711 | 2006-12-15 |
| 1891867313 | Visionary Minds Inc. | Psychologist | 315 W Ponce De Leon Ave., Ste 525, Decatur, GA 30030-2486 | 2006-11-14 |
| 1699844977 | Katherine Vivian Bruss | Psychologist | 1244 Clairmont Rd Ste 101, Decatur, GA 30030-1250 | 2006-11-08 |
| Find all providers in DECATUR | ||||
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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.