Healthcare Provider Details
I. General information
NPI: 1174149728
Provider Name (Legal Business Name): CHILDREN'S AUTISM ASSESSMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1866 INDEPENDENCE SQ
ATLANTA GA
30338-5150
US
IV. Provider business mailing address
1866 INDEPENDENCE SQ
ATLANTA GA
30338-5150
US
V. Phone/Fax
- Phone: 404-390-1322
- Fax: 404-835-0001
- Phone: 404-390-1322
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRANDI
D
SMITH
Title or Position: PSYCHOLOGIST, OWNER
Credential: PSY.D.
Phone: 478-319-6028