MEDICARE: DR. TINAI JAMES PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY004598	GA
2	103TC0700X	Clinical Psychologist	PSY31750	CA
3	103TC2200X	Clinical Child & Adolescent Psychologist	PSY004598	GA
4	103T00000X	Psychologist	PSY31750	CA
5	103TC0700X	Clinical Psychologist	PSY004598	GA
6	103TC2200X	Clinical Child & Adolescent Psychologist	PSY31750	CA

General Provider Information

NPI Number	:	1144606088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINAI JAMES PHD

Provider Business Mailing Address
First Line	:	285 BIRCH CREEK CIR
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-7258
Country	:	US
Telephone Number	:	415-672-4353
Fax Number	:

Provider Business Practice Location Address
First Line	:	285 BIRCH CREEK CIR
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-7258
Country	:	US
Telephone Number	:	415-672-4353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2015
Last Update Date	:	04/15/2026

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