PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES, LLC
PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES, LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1215357272, based in Douglasville, GA. The organization lists 15 taxonomy classifications, with Clinical Psychologist recorded as primary.
Getting there
The practice address on file is 6576 CHURCH ST, Douglasville, GA 30134. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| PSY003237 | GA | Clinical Psychologist primary |
This provider holds licence PSY003237 issued in GA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Clinical covers
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. NUCC Health Care Provider Taxonomy, code 103TC0700X
All registered taxonomy codes
This provider registers 15 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 103TC0700X | Clinical Psychologist Clinical | PSY003237 | GA | primary |
| 101Y00000X | Counselor | — | — | |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor Addiction (Substance Use Disorder) | — | — | |
| 101YP2500X | Professional Counselor Professional | — | — | |
| 104100000X | Social Worker | — | — | |
| 1041C0700X | Clinical Social Worker Clinical | — | — | |
| 106H00000X | Marriage & Family Therapist | — | — | |
| 133N00000X | Nutritionist | — | — | |
| 136A00000X | Registered Dietetic Technician | — | — | |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse Psychiatric/Mental Health | — | — | |
| 164W00000X | Licensed Practical Nurse | — | — | |
| 171100000X | Acupuncturist | — | — | |
| 171M00000X | Case Manager/Care Coordinator | — | — | |
| 2084P0800X | Psychiatry Physician Psychiatry | — | — | |
| 374700000X | Technician | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1215357272 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Apr 17, 2014 |
| Last updated | Apr 17, 2014 |
| Status | Active |
| Practice address |
6576 CHURCH ST Douglasville, GA 30134 (770) 577-7873 Fax (770) 577-7871 |
| Other identifiers |
003132073B
· Medicaid (GA) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 2 | 1 | 5 | 3 | 5 | 7 | 2 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 2 | 2 | 5 | 6 | 5 | 5 | 2 | 5 |
Sum = 58 · next multiple of 10 = 60 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.