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General NPI Number Information
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NPI Number | 1225078629
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Entity Type | Organization
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Legal Business Name | SENIOR PSYCH SOLUTIONS CORP
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 1050 CROWN POINTE PKWY SUITE 295
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City | ATLANTA
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State | GA
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Zip | 30338-7707
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Country | US
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Telephone | 866-325-5434
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Fax | 866-325-5340
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Provider Business Mailing Address
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Address Line | 1050 CROWN POINTE PKWY SUITE 295
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City | ATLANTA
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State | GA
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Zip | 30338-7707
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Country | US
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Telephone | 866-325-5434
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Fax | 866-325-5340
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | AMY SHAPIRO
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Credential |
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Telephone | 866-325-5434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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