Organization · Type 2 NPI

Wellstar Medical Group, LLC

Psychologist · Marietta, GA

NPI number 1114207461 Active

Practice location

55 Whitcher St NE, Suite 420
Marietta, GA 30060-1155

Fax (770) 794-8034

Specialties and licenses

Taxonomy	Code	License
Psychologist Primary	103T00000X	None listed

Psychologist: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustmen…

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NPI record

NPI: 1114207461
Entity type: Organization (Type 2)
Issued: Aug 18, 2011
Last updated: Nov 19, 2013
Status: Active
Subpart: Yes of Wellstar Medical Group, LLC

Other names

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Wellstar Psychological Services · doing business as

Authorized official

Mrs. Nicole Ashe
Executive Director of Finance
(470) 644-0095

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114207461

Wellstar Medical Group, LLC's National Provider Identifier is 1114207461, issued on Aug 18, 2011. The primary taxonomy on file is Psychologist (103T00000X), and the practice location is in Marietta, GA. The record was last updated on Nov 19, 2013.