DR. CHARLES E CANCILLA PH.D.
NPI 1700546488
Psychologist in Suwanee, GA

Active since December 22, 2021
897 EVA KENNEDY RD, SUWANEE, GA 30024(404) 400-2547 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Charles E Cancilla Ph.d. NPPES

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

DR. CHARLES E CANCILLA PH.D. (NPI 1700546488) is an individual psychologist in Suwanee, Georgia, licensed in Georgia (4473) and active in the NPI registry since December 2021.

NPPES Registry Identity

NPI1700546488
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. CHARLES E CANCILLACredential: PH.D.
Location Address897 EVA KENNEDY RDSuwanee, GA 30024-1911
Mailing Address2345 Duncans Shore DrBuford, GA 30519-6222 · (404) 218-0180
Sole ProprietorYes
Enumeration DateDecember 22, 2021
NPPES CertifiedDecember 22, 2021
NPI 1700546488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in GA · 4473
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.
897 EVA KENNEDY RD, Suwanee, GA 30024

Other Providers at the Same Location NPPES

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

Counselor (Professional)
897 EVA KENNEDY RD
SUWANEE, GA 30024

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 Charles Cancilla's NPI number?

The NPI number for Charles Cancilla is 1700546488. It was assigned to this individual provider in the NPPES registry on December 22, 2021.

Where is Charles Cancilla located?

Charles Cancilla practices at 897 Eva Kennedy Rd, Suwanee, GA 30024. The listed phone number is (404) 400-2547.

What is Charles Cancilla's specialty?

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

When was this NPI record last updated?

The NPPES record for Charles Cancilla was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.