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General NPI Number Information
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NPI Number | 1114037561
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Entity Type | Individual
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Provider Name | CARLA A HEDEEN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2665 N DECATUR RD SUITE 630
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City | DECATUR
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State | GA
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Zip | 30033-6149
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Country | US
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Telephone | 404-501-7569
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Fax | 404-501-7550
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Provider Business Mailing Address
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Address Line | PO BOX 1494
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City | DECATUR
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State | GA
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Zip | 30031-1494
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Country | US
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Telephone | 404-501-7569
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Fax | 404-501-7550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY001656
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY001656
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | PSY001656
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License Number State | GA
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