Healthcare Provider Details

I. General information

NPI: 1508679697
Provider Name (Legal Business Name): GEORGIA PSYCHIATRY & SLEEP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BALTIMORE PL NW STE 200
ATLANTA GA
30308-2114
US

IV. Provider business mailing address

1314 CONCORD RD SE
SMYRNA GA
30080-4361
US

V. Phone/Fax

Practice location:
  • Phone: 470-737-1606
  • Fax: 833-973-4256
Mailing address:
  • Phone: 770-438-1799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: HAPPY SHROFF
Title or Position: PRACTICE OFFICE MANAGER
Credential:
Phone: 770-833-6885