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General NPI Number Information
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NPI Number | 1225245202
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Entity Type | Individual
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Provider Name | JAMES M SIWY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 555 SUN VALLEY DR SUITE L-4
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City | ROSWELL
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State | GA
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Zip | 30076-5612
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Country | US
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Telephone | 770-641-7720
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Fax | 770-642-7957
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Provider Business Mailing Address
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Address Line | 390 N POND TRL
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City | ROSWELL
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State | GA
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Zip | 30076-2921
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Country | US
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Telephone | 770-641-7720
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Fax | 770-642-7957
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY000989
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | PSY000989
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License Number State | GA
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