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

Stephanie L. Ezust, Ph D , PC

Organization Clinical Psychologist · NPI 1821212341

Stephanie L. Ezust, Ph D , PC is a Clinical Psychologist in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1348 Ponce De Leon Ave NE
Atlanta, GA 30306-4604
Phone: (404) 371-9171
Fax: (404) 371-9172
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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 1513 (GA)

Record details

NPI number1821212341
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephanie Ezust — Owner · (404) 371-9171
NPI enumeratedApril 13, 2007
Last updated in NPPESFebruary 27, 2020
Certification dateFebruary 27, 2020
Mailing addressPo Box 1192, Decatur, GA 30031-1192

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