Healthcare Provider Details

I. General information

NPI: 1720133325
Provider Name (Legal Business Name): SREEDEVI VAYALAPALLI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 SCALES RD STE 302
SUWANEE GA
30024-4342
US

IV. Provider business mailing address

950 SCALES RD STE 302
SUWANEE GA
30024-4342
US

V. Phone/Fax

Practice location:
  • Phone: 404-994-5000
  • Fax: 888-264-8367
Mailing address:
  • Phone: 404-994-5000
  • Fax: 888-264-8367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberPSY003180
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPSY003180
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY003180
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License NumberPSY003180
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number059226
License Number StateGA
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number059226
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number68148
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: