Healthcare Provider Details

I. General information

NPI: 1457563637
Provider Name (Legal Business Name): MILLIE C. ASTIN, PHD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 CENTURY BLVD. SUITE B
ATLANTA GA
30345-3322
US

IV. Provider business mailing address

1790 CENTURY BLVD. SUITE B
ATLANTA GA
30345-3322
US

V. Phone/Fax

Practice location:
  • Phone: 404-248-1023
  • Fax:
Mailing address:
  • Phone: 404-248-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY 002201
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 002201
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 002201
License Number StateGA

VIII. Authorized Official

Name: DR. MILLIE C. ASTIN
Title or Position: OWNER
Credential: PHD
Phone: 404-248-1023