Maddox, Samuel Jermaine

Maddox, Samuel Jermaine is an sole proprietor health care provider with primary practice located at 1777 Northeast Expy Ne Suite 175, Atlanta GA 30329-2480. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Maddox, Samuel Jermaine can be contacted via phone (678) 523-0969.

Contact Information

Primary practice address
1777 Northeast Expy Ne Suite 175 Atlanta GA 30329-2480
Phone: (678) 523-0969
Fax: (770) 788-7662
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY002983 Georgia
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY002983 Georgia
Behavioral Health & Social Service Providers / Family 103TF0000X PSY002983 Georgia
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X PSY002983 Georgia

Profile Details

NPI number 1093904260
LBN Legal business name Maddox, Samuel Jermaine
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 23rd, 2007
Last updated Oct 23rd, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers