| Cheryl Coletta Psy D Pc | |
|
125 Townpark Dr Nw Ste 300 Kennesaw GA 30144-3231 | |
| (561) 279-5599 | |
| Not Available |
| Full Name | Cheryl Coletta Psy D Pc |
|---|---|
| Speciality | Psychologist |
| Location | 125 Townpark Dr Nw Ste 300, Kennesaw, Georgia |
| Authorized Official Name and Position | Cheryl Coletta (OWNER/PRESIDENT) |
| Authorized Official Contact | 5612795599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheryl Coletta Psy D Pc 125 Townpark Dr Nw Ste 300 Kennesaw GA 30144-3231 Ph: (561) 279-5599 | Cheryl Coletta Psy D Pc 125 Townpark Dr Nw Ste 300 Kennesaw GA 30144-3231 Ph: (561) 279-5599 |
| NPI Number | 1922829068 |
|---|---|
| Provider Enumeration Date | 10/22/2024 |
| Last Update Date | 10/22/2024 |
| Certification Date | 10/16/2024 |
| Medicare PECOS PAC ID | 7911427406 |
|---|---|
| Medicare Enrollment ID | O20250227001973 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922829068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Cheryl Nancy Coletta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356774061 PECOS PAC ID: 3678703386 Enrollment ID: I20250409000281 |
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