Healthcare Provider Details

I. General information

NPI: 1245092774
Provider Name (Legal Business Name): KINDRED PSYCHIATRIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 01/30/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3437 CATALAN ALY
DECATUR GA
30032-5868
US

IV. Provider business mailing address

3437 CATALAN ALY
DECATUR GA
30032-5868
US

V. Phone/Fax

Practice location:
  • Phone: 770-410-8862
  • Fax:
Mailing address:
  • Phone: 770-410-8862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAMILLE WILLIAMS
Title or Position: OWNER/PSYCHIATRIST
Credential: MD
Phone: 770-410-8862