Provider Demographics
NPI:1356693212
Name:TOWNSEND, NATHAN ANDREW (PSYD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ANDREW
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 N HIGHLAND AVE NE
Mailing Address - Street 2:SUITE J
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3300
Mailing Address - Country:US
Mailing Address - Phone:678-802-9091
Mailing Address - Fax:
Practice Address - Street 1:1409 N HIGHLAND AVE NE
Practice Address - Street 2:SUITE J
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3300
Practice Address - Country:US
Practice Address - Phone:678-802-9091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003608103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical