| Provider / Organization | NPI | Date Certified |
|---|---|---|
| STELLA DIMARIS CRUZ RODRIGUEZ | 1578162970 | 2022-07-30 |
Stella Dimaris Cruz Rodriguez [F] graduated in 2019 and primarily specializes in Psychologist, Clinical.
Stella Dimaris Cruz Rodriguez is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1578162970. Registration indicates Stella Dimaris Cruz Rodriguez is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Psychologist (Behavioral Health & Social Service Providers, Psychologist) (Psychologist, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Psychologist, Behavioral Health & Social Service Providers)
| PECOS ID | 8224440490 |
| Registration | PART-B:Y DME:Y HHA:N PMD:N |
| Entity Type | Individual |
| Provider Name | Stella Dimaris Cruz Rodriguez PSYD |
| Practice Office Address | 5185 OLD NATIONAL HWY ATLANTA, GA US |
| Practice Office Telephone | 4705683611 |
| Mailing Address | 1025 VETERANS MEMORIAL HWY SE STE 660 MABLETON, GA 301267711 US |
| Business Telephone | 4705683611 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 3372 Peachtree Rd NE Ste 115 | Atlanta, GA 303261963 | 4705683611 |
| Carequality [C-CDA] | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
| Other URL [] | sondermind.com | SonderMind Provider Network LLC |
| Other URL [] | www.pathmentalhealth.com | MENTAL HEALTH SPECIALTY GROUP, P.A. |
| Code | Practice | License No State |
|---|---|---|
| 103T00000X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Psychologist Behavioral Health & Social Service Providers Psychologist Psychologist Behavioral Health/Substance Abuse/Psychiatry Psychologist Behavioral Health & Social Service Providers | PSY004432
GA |