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General NPI Number Information
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NPI Number | 1962977363
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Entity Type | Organization
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Legal Business Name | PSYCHED INC
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 10/11/2018
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Provider Practice Location Address
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Address Line | 5755 N POINT PKWY STE 205
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City | ALPHARETTA
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State | GA
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Zip | 30022-1170
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Country | US
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Telephone | 844-779-2487
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Fax | 844-779-2487
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Provider Business Mailing Address
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Address Line | 4575 WEBB BRIDGE RD STE 4911
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City | ALPHARETTA
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State | GA
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Zip | 30005-4256
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Country | US
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Telephone | 844-779-2487
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Fax | 844-779-2487
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Authorized Official
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Title or Position | CEO
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Name | JAI DAMES
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Credential | LMFT
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Telephone | 844-779-2487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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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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