{"npi":"1316216880","type":"NPI-2","status":"active","name":{"display":"Southeastern Psychological Associates, INC","other":[],"organization_name":"SOUTHEASTERN PSYCHOLOGICAL ASSOCIATES, INC","authorised_official":"Priscilla Faulkner"},"specialty":{"primary_taxonomy":"103TC2200X","primary_taxonomy_description":"Clinical Child & Adolescent Psychologist","slug":"clinical-child-adolescent-psychologist","schema_org_specialty":null,"all":[{"code":"103TC2200X","description":"Clinical Child & Adolescent Psychologist","primary":true,"state":"GA","license":"PSY002144"}]},"addresses":[{"purpose":"LOCATION","street_1":"3155 MILL STREET","city":"COVINGTON","state":"GA","postal_code":"30014","country_code":"US","phone":"4042260939","fax":"6788020939"},{"purpose":"MAILING","street_1":"3155 MILL STREET","city":"COVINGTON","state":"GA","postal_code":"300142542","country_code":"US","phone":"6787126520","fax":"6787126521"}],"license":{"state":"GA","number":"PSY002144"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20120405000302","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"GA","pac_id":"9537320254"}]},"enumeration_date":"2011-12-29","last_updated":"2017-05-03","_meta":{"source":"NPPES","snapshot_date":"2017-05-03","doc_url":"https://findmynpi.com/api"}}