Healthcare Provider Details

I. General information

NPI: 1891867750
Provider Name (Legal Business Name): CATHY M. TENCH, PSY. D., P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 N BROAD ST SUITE 2
TOCCOA GA
30577-2337
US

IV. Provider business mailing address

PO BOX 1241
TOCCOA GA
30577-1421
US

V. Phone/Fax

Practice location:
  • Phone: 706-886-1101
  • Fax: 706-886-0401
Mailing address:
  • Phone: 706-886-1101
  • Fax: 706-886-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 002253
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CATHY M. TENCH
Title or Position: OWNER
Credential: PSY. D.
Phone: 770-519-2047