Healthcare Provider Details

I. General information

NPI: 1427170745
Provider Name (Legal Business Name): PEACHTREE PSYCHIATRIC PROFESSIONALS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 PIEDMONT RD NE SUITE 775
ATLANTA GA
30305-1507
US

IV. Provider business mailing address

3500 PIEDMONT RD NE SUITE 775
ATLANTA GA
30305-1507
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-2008
  • Fax: 404-351-0243
Mailing address:
  • Phone: 404-351-2008
  • Fax: 404-351-0243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1664
License Number StateGA

VIII. Authorized Official

Name: DR. STEVEN HAMILTON LITTRELL
Title or Position: PSYCHOTHERAPIST
Credential: PHD
Phone: 404-351-2008