COASTAL GEORGIA PSYCHODYNAMIC CENTER, LLC
NPI 1871033654
Psychologist - Clinical in Statesboro, GA

Q: What is Coastal Georgia Psychodynamic Center, LLC's specialty?

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

Active since February 28, 2017

325 S WALNUT ST, STATESBORO, GA 30458(912) 421-9050(912) 623-4918 Get Directions Write a Review

NPPES record last updated: May 11, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 11, 2020, Feb 28, 2018, Feb 28, 2017 (3 updates tracked since 2017).

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About Coastal Georgia Psychodynamic Center, Llc NPPES

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

COASTAL GEORGIA PSYCHODYNAMIC CENTER, LLC (NPI 1871033654) is a healthcare organization registered as a clinical in Statesboro, Georgia and active in the NPI registry since February 2017. The organization lists Amanda Rickard, Organizer, as its authorized official.

NPPES Registry Identity

NPI1871033654

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameCOASTAL GEORGIA PSYCHODYNAMIC CENTER, LLC

Location Address325 S WALNUT STStatesboro, GA 30458-5418

Mailing Address325 S Walnut StStatesboro, GA 30458-5418 · (912) 421-9050 · Fax (912) 623-4918

Phone(912) 421-9050

Fax(912) 623-4918

Organization SubpartNo

Authorized OfficialAmanda RickardOrganizer · (912) 421-9050

Enumeration DateFebruary 28, 2017

Last NPPES UpdateMay 11, 20203 updates tracked since enumeration

NPPES CertifiedMay 11, 2020

✔ NPI 1871033654 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 · PSY003907

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.

325 S WALNUT ST, Statesboro, GA 30458

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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

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 Coastal Georgia Psychodynamic Center, LLC's NPI number?

The NPI number for Coastal Georgia Psychodynamic Center, LLC is 1871033654. It was assigned to this organization in the NPPES registry on February 28, 2017.

Where is Coastal Georgia Psychodynamic Center, LLC located?

Coastal Georgia Psychodynamic Center, LLC is located at 325 S Walnut St, Statesboro, GA 30458. The listed phone number is (912) 421-9050.

What is Coastal Georgia Psychodynamic Center, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Coastal Georgia Psychodynamic Center, LLC was last updated on May 11, 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.