Healthcare Provider Details
I. General information
NPI: 1083559231
Provider Name (Legal Business Name): CLINICAL & CONSULTING SERVICES OF ATLANTA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 PEACHTREE ST NW STE 335
ATLANTA GA
30309-2508
US
IV. Provider business mailing address
1800 PEACHTREE ST NW STE 335
ATLANTA GA
30309-2508
US
V. Phone/Fax
- Phone: 404-948-2426
- Fax: 404-948-2427
- Phone: 404-948-2426
- Fax: 404-948-2427
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TROY
AVIS
JAMES
Title or Position: OWNER/CEO
Credential: PHD, MSCP
Phone: 404-948-2426