Credidio, Michael John

Credidio, Michael John is an individual health care provider with primary practice located at 2 Lee Street Suite A, Newnan GA 30263-7508. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Credidio, Michael John can be contacted via phone (678) 326-4488.

Contact Information

Primary practice address
2 Lee Street Suite A Newnan GA 30263-7508
Phone: (678) 326-4488
Fax: (678) 669-2693
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY002670 Georgia

Profile Details

NPI number 1669536405
LBN Legal business name Credidio, Michael John
Credentials PSY D
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Apr 2nd, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669536405 NPPES
Georgia MEDICAID 281868610A
Georgia MEDICAID 281868610C

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