Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Coastal Georgia Psychodynamic Center, LLC

Organization Clinical Psychologist · NPI 1871033654

Coastal Georgia Psychodynamic Center, LLC provides Clinical Psychologist services in Statesboro, Georgia. Licensed in Georgia. Registered with an NPI since 2017.

Licensed in
GA
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

325 S Walnut St
Statesboro, GA 30458-5418
Phone: (912) 421-9050
Fax: (912) 623-4918
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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 PSY003907 (GA)

Record details

NPI number1871033654
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amanda Rickard — Organizer · (912) 421-9050
NPI enumeratedFebruary 28, 2017
Last updated in NPPESMay 11, 2020
Certification dateMay 11, 2020
Mailing address325 S Walnut St, Statesboro, GA 30458-5418

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