NPI age
7 years
Enumerated 2018-10-27
● Active
Type 1 · Individual
Dia Boutwell, PHD
Boutwell is 1 of 10 psychologist providers in Fayetteville and 1 of 1487 in Georgia.
Primary specialty
Psychologist
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2020-02-21
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 1487 active psychologist providers in Georgia.
NPI age
7 years
↓ 10 yr below median (17 yr)
State licenses
1 state
6% of peers hold multiple states
Subspecialties
0
18% of peers hold subspecialties
NPI lifetime · 2018 → 2026
2018-10Enumerated in NPPES
2018
2026
Where they practice
Practice location
125 Howard Ln Ste B
Fayetteville, GA 302151853
Mailing address
125 Howard Ln Ste B
Fayetteville, GA 302151853
Specialties
-
Psychologist PrimaryA 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...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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