MEDICARE: DR. KATHY FERRELL-SWANN PH.D.

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	2438	GA
2	103TC1900X	Counseling Psychologist	2438	GA
3	103TC2200X	Clinical Child & Adolescent Psychologist	2438	GA
4	103TF0000X	Family Psychologist	2438	GA

General Provider Information

NPI Number	:	1871626390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHY FERRELL-SWANN PH.D.

Provider Business Mailing Address
First Line	:	6000 LAKE FORREST DR NW
Second Line	:	SUITE 575
City	:	ATLANTA
State	:	GA
Zip	:	30328-3824
Country	:	US
Telephone Number	:	404-252-0022
Fax Number	:	404-255-3234

Provider Business Practice Location Address
First Line	:	6000 LAKE FORREST DR NW
Second Line	:	SUITE 575
City	:	ATLANTA
State	:	GA
Zip	:	30328-3824
Country	:	US
Telephone Number	:	404-252-0022
Fax Number	:	404-255-3234

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	09/11/2025

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