| Pioneer Psychological Associates, Llc | |
|
5605 Glenridge Dr Ne Suite 600 Atlanta GA 30342-1365 | |
| (404) 723-5633 | |
| Not Available |
| Full Name | Pioneer Psychological Associates, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5605 Glenridge Dr Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Daniel Wachtel (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 4047235633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pioneer Psychological Associates, Llc 860 Johnson Ferry Rd Ste 140-172 Atlanta GA 30342-1435 Ph: (404) 723-5633 | Pioneer Psychological Associates, Llc 5605 Glenridge Dr Ne Suite 600 Atlanta GA 30342-1365 Ph: (404) 723-5633 |
| NPI Number | 1326317488 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 3072780717 |
|---|---|
| Medicare Enrollment ID | O20120119000786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326317488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY003012 (Georgia) | Primary |
| Provider Name | Daniel J Wachtel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255463873 PECOS PAC ID: 2466550587 Enrollment ID: I20070613000119 |
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