| Northeast Georgia Psychological Services Llc | |
|
4073 Highway 53 Hoschton GA 30548-2305 | |
| (770) 882-5884 | |
| Not Available |
| Full Name | Northeast Georgia Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4073 Highway 53, Hoschton, Georgia |
| Authorized Official Name and Position | Heather Futral (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6786136643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Georgia Psychological Services Llc 4073 Highway 53 Hoschton GA 30548-2305 Ph: () - | Northeast Georgia Psychological Services Llc 4073 Highway 53 Hoschton GA 30548-2305 Ph: (770) 882-5884 |
| NPI Number | 1407230410 |
|---|---|
| Provider Enumeration Date | 07/20/2015 |
| Last Update Date | 10/16/2015 |
| Medicare PECOS PAC ID | 1850600891 |
|---|---|
| Medicare Enrollment ID | O20151014001687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407230410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY003418 (Georgia) | Primary |
| Provider Name | Deborah Gunnin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588225619 PECOS PAC ID: 0840222444 Enrollment ID: I20050902000657 |
| Provider Name | Julie A Pope |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447378344 PECOS PAC ID: 7315123809 Enrollment ID: I20110518000235 |
| Provider Name | Heather Chelsey Futral |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487954384 PECOS PAC ID: 2769791706 Enrollment ID: I20151014001892 |
| Provider Name | Mercedes M Kamerman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487103834 PECOS PAC ID: 1052691490 Enrollment ID: I20161201000730 |
| Provider Name | Vanessa Pellicci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689883332 PECOS PAC ID: 2860732757 Enrollment ID: I20190312001943 |
| Provider Name | Florin Selagea |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427464536 PECOS PAC ID: 9638509599 Enrollment ID: I20200417001307 |
| Provider Name | Lydia Breer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194357913 PECOS PAC ID: 9830512656 Enrollment ID: I20200711000001 |
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