| Psychiatric Professionals Of Georgia, Llc | |
|
1325 Satellite Blvd Nw Bldg 400 Suwanee GA 30024-4651 | |
| (678) 263-3080 | |
| (678) 496-9863 |
| Full Name | Psychiatric Professionals Of Georgia, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1325 Satellite Blvd Nw Bldg 400, Suwanee, Georgia |
| Authorized Official Name and Position | Kaley Davis (PROVIDER ENROLLMENT ASSOCIATE) |
| Authorized Official Contact | 4708574412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Professionals Of Georgia, Llc 1325 Satellite Blvd Nw Bldg 400 Suwanee GA 30024-4651 Ph: (678) 263-3080 | Psychiatric Professionals Of Georgia, Llc 1325 Satellite Blvd Nw Bldg 400 Suwanee GA 30024-4651 Ph: (678) 263-3080 |
| NPI Number | 1396277968 |
|---|---|
| Provider Enumeration Date | 04/01/2017 |
| Last Update Date | 03/31/2025 |
| Certification Date | 03/31/2025 |
| Medicare PECOS PAC ID | 2567731482 |
|---|---|
| Medicare Enrollment ID | O20170710001727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396277968 | NPI | - | NPPES |
| Provider Name | Benjamin C Akosa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255427225 PECOS PAC ID: 3779517255 Enrollment ID: I20050923000522 |
| Provider Name | Ana R. Segarra-brechtel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952596157 PECOS PAC ID: 5496820839 Enrollment ID: I20080819000524 |
| Provider Name | Heerain A Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134346828 PECOS PAC ID: 8123116399 Enrollment ID: I20100715000195 |
| Provider Name | Mahendra R Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326122367 PECOS PAC ID: 0840375721 Enrollment ID: I20101115001043 |
| Provider Name | Manuel Mota Castillo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003867698 PECOS PAC ID: 9133179567 Enrollment ID: I20101208000975 |
| Provider Name | Neesha A Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285838516 PECOS PAC ID: 4880877208 Enrollment ID: I20110323000222 |
| Provider Name | Vinay Nagaraj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952585424 PECOS PAC ID: 8921159872 Enrollment ID: I20120921000560 |
| Provider Name | Parul Dev |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962610634 PECOS PAC ID: 9931275229 Enrollment ID: I20130611000776 |
| Provider Name | Michael K Frech |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093076374 PECOS PAC ID: 6901032929 Enrollment ID: I20131122000386 |
| Provider Name | Monique Mcgee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104284389 PECOS PAC ID: 2860797792 Enrollment ID: I20160301001904 |
| Provider Name | Samuel Joshua Dotson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811417041 PECOS PAC ID: 3577836741 Enrollment ID: I20231113001068 |
| Provider Name | Bipinchandra Hirisave Krishna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386854651 PECOS PAC ID: 6608043203 Enrollment ID: I20231229000856 |
| Provider Name | Stephen Brogdon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275702136 PECOS PAC ID: 0345411401 Enrollment ID: I20240812000433 |
| Provider Name | Annamarie S Paulsen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285766055 PECOS PAC ID: 4284160466 Enrollment ID: I20241211002087 |
| Provider Name | Laura Angley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538740022 PECOS PAC ID: 2466980511 Enrollment ID: I20250116002967 |
| Provider Name | Katherine A Mckee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043030281 PECOS PAC ID: 4587193339 Enrollment ID: I20250124000045 |
| Provider Name | Carol Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053998666 PECOS PAC ID: 1951831924 Enrollment ID: I20250205002832 |
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