Healthcare Provider Details

I. General information

NPI: 1689103376
Provider Name (Legal Business Name): MEGAN RYAN SCHMIDT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2964 PEACHTREE RD NW STE 324
ATLANTA GA
30305-2120
US

IV. Provider business mailing address

2964 PEACHTREE RD NW STE 324
ATLANTA GA
30305-2120
US

V. Phone/Fax

Practice location:
  • Phone: 706-474-8226
  • Fax: 770-953-4640
Mailing address:
  • Phone: 706-474-8226
  • Fax: 770-953-4640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY004521
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: