Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Psychogenesis, Inc

Organization Clinical Psychologist · NPI 1083779763

Psychogenesis, Inc is a Clinical Psychologist in Rome, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

519 Broad St Ste 202
Rome, GA 30161-1734
Phone: (706) 232-5544
Fax: (888) 543-1173
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 2075 (GA)

Record details

NPI number1083779763
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Judith Tutin — President · (706) 232-5544
NPI enumeratedDecember 24, 2006
Last updated in NPPESDecember 3, 2015
Mailing address2 Windsor Rd Sw, Rome, GA 30165-8555

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