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General NPI Number Information
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NPI Number | 1487621827
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Entity Type | Organization
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Legal Business Name | CHRISTIAN PSYCHOTHERAPY RESOURCES, INC.
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1360 CADUCEUS WAY STE 102
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City | WATKINSVILLE
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State | GA
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Zip | 30677-7300
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Country | US
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Telephone | 706-282-8442
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Fax | 706-310-6907
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Provider Business Mailing Address
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Address Line | 115 MOSS SIDE DR
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City | ATHENS
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State | GA
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Zip | 30607-2108
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Country | US
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Telephone | 706-308-7403
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Fax | 706-310-6907
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. JONATHAN CRAWFORD ROBINSON
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Credential | PH.D.
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Telephone | 706-549-5248
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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 | 001974
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License Number State | GA
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