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NPI 1639439201
● Active Type 2 · Organization
Living Fully Psychological Services, Llc
Psychologist · Decatur, GA · NPI 1639439201
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Enumerated 2012 · 14 years on NPI
Living Fully Psychological Services, Llc is 1 of 1487 psychologist organizations in Georgia.
NPI age
14 years
Enumerated 2012-05-17
Primary specialty
Psychologist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Moghaddam
Director
Last NPPES update
2013-03-04
Source: monthly bulk 2026-05
How this organization compares
Across 1487 active psychologist providers in Georgia.
NPI age
14 years
↓ 3 yr below median
Practice locations
1
0 secondary on file
NPI lifetime · 2012 → 2026
2012-05 Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
111 N McDonough St
Decatur, GA 300303317
📞 6785919117 fax 7704588640
Mailing address
111 N McDonough St
Decatur, GA 300303317
📞 6785919117 fax 7704588640
Authorized official
Pegah Moghaddam, PSY.D.
Director
📞 6785919117
Individual providers at this organization
8 individual providers on file at this primary practice address.
Jaime Blandino , PH.D.
Psychologist
NPI 1558501684
Sylvia Browning , MA, LPC, LMHC
Counselor
NPI 1346648847
Elaina Chance , LPC
Counselor
NPI 1174864029
Tamara Godfrey , PHD
Psychologist
NPI 1245537562
Elisabeth Groth , PH.D.
Psychologist
NPI 1487876322
Nattan Hollander , M.F.T.
Marriage & Family Therapist
NPI 1013306661
Patrice Mann , MD
Psychiatry & Neurology
NPI 1689106643
Alison Nathanson , PHD
Psychologist
NPI 1073897088
Specialties
Psychologist
Primary
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...
GA license #PSY003405 taxonomy 103TC0700X
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Practice context
Multi-provider organization.
8 individual providers on file at this primary address.
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How to verify this organization
Confirm the NPI on NPPES. The CMS registry is the system of record. Open NPPES →
Verify the organization is in good standing. Cross-check with the state's business registration and any applicable licensing boards.
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Updated 2026-05-14
· Source: CMS NPPES bulk export. Praxis MD refreshes the directory monthly with weekly delta updates.
Independent public resource. Not affiliated with CMS, HHS, or NPPES. Not endorsed by the U.S. government.
NPI listing is not proof of active licensure or payer enrollment.