MEDICARE: ATLANTA PSYCHIATRIC AND PSYCHOLOGICAL SERVICES, INC.

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	103TC0700X	Clinical Psychologist		GA

General Provider Information

NPI Number	:	1356585962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA PSYCHIATRIC AND PSYCHOLOGICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	1955 CLIFF VALLEY WAY NE
Second Line	:	SUITE 110
City	:	ATLANTA
State	:	GA
Zip	:	30329-2476
Country	:	US
Telephone Number	:	404-315-9559
Fax Number	:	404-315-9557

Provider Business Practice Location Address
First Line	:	1955 CLIFF VALLEY WAY NE
Second Line	:	SUITE 110
City	:	ATLANTA
State	:	GA
Zip	:	30329-2476
Country	:	US
Telephone Number	:	404-315-9559
Fax Number	:	404-315-9557

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRANNON L WEEKS
Credential	:	M.D.
Telephone Number	:	404-315-9559

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	04/27/2009

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