Healthcare Provider Details

I. General information

NPI: 1215649967
Provider Name (Legal Business Name): COMMENCEMENT FORENSIC PSYCHOLOGY EVALUATION TREATMENT & CONSULTATION, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 RIDENOUR BLVD NW STE 100
KENNESAW GA
30152-4528
US

IV. Provider business mailing address

2774 COBB PKWY NW SUITE 109, #379
KENNESAW GA
30152
US

V. Phone/Fax

Practice location:
  • Phone: 470-407-3127
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SYNITA HUDGINS
Title or Position: CEO
Credential: PHD
Phone: 404-419-7159