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NPI Code Detail

MEDICARE: QUARELLS CONSULTING, P.C.

MEDICARE: QUARELLS CONSULTING, P.C.
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
1103TC0700XClinical PsychologistPSY002525GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386801454
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUARELLS CONSULTING, P.C.
Provider Business Mailing Address
First Line : 1850 LAKE PARK DRIVE SE
Second Line : SUITE 106
City : SMYRNA
State : GA
Zip : 30080-7647
Country : US
Telephone Number : 770-403-3124
Fax Number : 770-739-7659
Provider Business Practice Location Address
First Line : 1850 LAKE PARK DR SE STE 106
Second Line :
City : SMYRNA
State : GA
Zip : 30080-7642
Country : US
Telephone Number : 770-403-3124
Fax Number : 770-739-7659
Authorized Official
Title or Position : CEO
Name : DR. CARLTON L. QUARELLS
Credential : PSY.D.
Telephone Number : 770-403-3124
Provider Enumeration Date : 05/16/2008
Last Update Date : 07/21/2022

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