PEGAH MOGHADDAM PSY. D
NPI 1376841296
Psychologist in Atlanta, GA

Active since March 01, 2011Opted out of Medicare · through Feb 13, 2028
4536 BARCLAY DR, SUITE A, ATLANTA, GA 30338(770) 458-8711(770) 458-8640 Get Directions Write a Review

NPPES record last updated: March 3, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pegah Moghaddam Psy. D NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEGAH MOGHADDAM PSY. D (NPI 1376841296) is an individual psychologist in Atlanta, Georgia and active in the NPI registry since March 2011. She has opted out of Medicare through February 13, 2028.

NPPES Registry Identity

NPI1376841296
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NamePEGAH MOGHADDAMCredential: PSY. D
Location Address4536 BARCLAY DR, SUITE AAtlanta, GA 30338-7145
Mailing Address4536 Barclay Dr, Suite AAtlanta, GA 30338-7145 · (770) 458-8711 · Fax (770) 458-8640
Fax(770) 458-8640
Sole ProprietorYes
Enumeration DateMarch 1, 2011
Last NPPES UpdateMarch 3, 2011
NPI 1376841296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
4536 BARCLAY DR, Atlanta, GA 30338

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Pegah Moghaddam Psy. D has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 13, 2024 through February 13, 2028.

Opt-Out Effective DateFebruary 13, 2024
Opt-Out In Effect ThroughFebruary 13, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
4536 BARCLAY DR, SUITE A
ATLANTA, GA 30338
Counselor (Mental Health)
4536 BARCLAY DR, SUITE A
ATLANTA, GA 30338
Nutritionist
4536 BARCLAY DR
ATLANTA, GA 30338
Counselor (Professional)
4536 BARCLAY DR, SUITE A
ATLANTA, GA 30338
Clinic/Center (Adult Mental Health)
4536 BARCLAY DR
ATLANTA, GA 30338
Marriage & Family Therapist
4536 BARCLAY DR, SUITE A
ATLANTA, GA 30338
Clinic/Center (Mental Health (Including Community Mental Health Center))
4536 BARCLAY DR
ATLANTA, GA 30338
Psychologist (Clinical)
4536 BARCLAY DR, SUITE A
ATLANTA, GA 30338

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pegah Moghaddam's NPI number?

The NPI number for Pegah Moghaddam is 1376841296. It was assigned to this individual provider in the NPPES registry on March 1, 2011.

Where is Pegah Moghaddam located?

Pegah Moghaddam practices at 4536 Barclay Dr Suite A, Atlanta, GA 30338. The listed phone number is (770) 458-8711.

What is Pegah Moghaddam's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Pegah Moghaddam enrolled in Medicare?

No. Pegah Moghaddam has opted out of Medicare through February 13, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Pegah Moghaddam was last updated on March 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.