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SUPPORTIVE CARE OF GEORGIA LLC
NPI 1891362877
Psychologist - Clinical in Roswell, GA

Active since June 08, 2021
300 COLONIAL CENTER PKWY STE 100N, ROSWELL, GA 30076(718) 298-4375 Get Directions Write a Review

NPPES record last updated: June 8, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Supportive Care Of Georgia Llc NPPES

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

SUPPORTIVE CARE OF GEORGIA LLC (NPI 1891362877) is a healthcare organization registered as a clinical in Roswell, Georgia and active in the NPI registry since June 2021. The organization lists Raphael Lichtschein, President, as its authorized official.

NPPES Registry Identity

NPI1891362877
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameSUPPORTIVE CARE OF GEORGIA LLC
Location Address300 COLONIAL CENTER PKWY STE 100NRoswell, GA 30076-4892
Mailing Address27 Randolph RdHowell, NJ 07731-8611 · (718) 298-4375
Phone(718) 298-4375
Organization SubpartNo
Authorized OfficialRaphael LichtscheinPresident · (718) 298-4375
Enumeration DateJune 8, 2021
NPPES CertifiedJune 8, 2021
✔ NPI 1891362877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
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.
300 COLONIAL CENTER PKWY STE 100N, Roswell, GA 30076
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Supportive Care Of Georgia Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Supportive Care Of Georgia LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (3)

Contessa Metcalfe, M.D.
Psychiatry
NPI 1639133135
80 W WIEUCA RD NE STE 201
Atlanta, GA 30342
(470) 443-8988
✔ PECOS12 mi
Sebrina Russell
Clinical Social Worker
NPI 1285266734
409 ARROWHEAD BLVD STE C1&C2
Jonesboro, GA 30236
(404) 391-7675
✔ PECOS✔ Accepts Medicare32 mi
Robert Glenn, MD
Psychiatry
NPI 1902033210
501 W REDLANDS BLVD STE B
Redlands, CA 92373
(909) 686-6233
✔ PECOS✔ Accepts Medicare1,876 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 Supportive Care Of Georgia LLC's NPI number?

The NPI number for Supportive Care Of Georgia LLC is 1891362877. It was assigned to this organization in the NPPES registry on June 8, 2021.

Where is Supportive Care Of Georgia LLC located?

Supportive Care Of Georgia LLC is located at 300 Colonial Center Pkwy Ste 100N, Roswell, GA 30076. The listed phone number is (718) 298-4375.

What is Supportive Care Of Georgia LLC's specialty?

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

Is Supportive Care Of Georgia LLC enrolled in Medicare?

Yes. Supportive Care Of Georgia LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Supportive Care Of Georgia LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Supportive Care Of Georgia LLC, in Clinical Social Worker and Psychiatry. 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 Supportive Care Of Georgia LLC was last updated on June 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.