STEPHANIE L. EZUST, PH.D., PC
NPI 1821212341
Psychologist - Clinical in Atlanta, GA

Q: What is Stephanie L. Ezust, Ph.D., PC's NPI number?

The NPI number for Stephanie L. Ezust, Ph.D., PC is 1821212341. It was assigned to this organization in the NPPES registry on April 13, 2007.

Q: What is Stephanie L. Ezust, Ph.D., PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since April 13, 2007

1348 PONCE DE LEON AVE NE, ATLANTA, GA 30306(404) 371-9171(404) 371-9172 Get Directions Write a Review

NPPES record last updated: February 27, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Stephanie L. Ezust, Ph.d., Pc NPPES

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

STEPHANIE L. EZUST, PH.D., PC (NPI 1821212341) is a healthcare organization registered as a clinical in Atlanta, Georgia and active in the NPI registry since April 2007. The organization lists Stephanie L. Ezust, Owner, as its authorized official.

NPPES Registry Identity

NPI1821212341

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameSTEPHANIE L. EZUST, PH.D., PC

Location Address1348 PONCE DE LEON AVE NEAtlanta, GA 30306-4604

Mailing AddressPo Box 1192Decatur, GA 30031-1192 · (404) 371-9171 · Fax (404) 371-9172

Phone(404) 371-9171

Fax(404) 371-9172

Organization SubpartNo

Authorized OfficialStephanie L. EzustOwner · (404) 371-9171

Enumeration DateApril 13, 2007

Last NPPES UpdateFebruary 27, 2020

✔ NPI 1821212341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in GA · 1513

Definition

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.

1348 PONCE DE LEON AVE NE, Atlanta, GA 30306

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stephanie L. Ezust, Ph.d., Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Stephanie L. Ezust, Ph.D., PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Stephanie Ezust, PH.D.

Clinical Psychologist

NPI 1164589156

317 W HILL ST SUITE 101
Decatur, GA 30030

(404) 371-9171

✔ PECOS✔ Accepts Medicare2.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Stephanie L. Ezust, Ph.D., PC's NPI number?

The NPI number for Stephanie L. Ezust, Ph.D., PC is 1821212341. It was assigned to this organization in the NPPES registry on April 13, 2007.

Where is Stephanie L. Ezust, Ph.D., PC located?

Stephanie L. Ezust, Ph.D., PC is located at 1348 Ponce De Leon Ave NE, Atlanta, GA 30306. The listed phone number is (404) 371-9171.

What is Stephanie L. Ezust, Ph.D., PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Stephanie L. Ezust, Ph.D., PC enrolled in Medicare?

Yes. Stephanie L. Ezust, Ph.D., PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stephanie L. Ezust, Ph.D., PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Stephanie L. Ezust, Ph.D., PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Stephanie L. Ezust, Ph.D., PC was last updated on February 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.