Healthcare Provider Details

I. General information

NPI: 1629088984
Provider Name (Legal Business Name): PSYCHIATRIC CONSULTANTS OF ATLANTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 HIGHTOWER TRL
ATLANTA GA
30350-2923
US

IV. Provider business mailing address

990 HAMMOND DR STE 525
ATLANTA GA
30328-5529
US

V. Phone/Fax

Practice location:
  • Phone: 770-234-0981
  • Fax: 770-626-4226
Mailing address:
  • Phone: 770-234-0981
  • Fax: 770-626-4226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number53850
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number53850
License Number StateGA

VIII. Authorized Official

Name: DR. BRYON KIRKLAND EVANS
Title or Position: OWNER/CEO
Credential: M.D.
Phone: 770-234-0981