Psychogenesis, Inc.
Psychogenesis, Inc. is a healthcare organization registered as Clinical Psychologist in Rome, GA, holding Type 2 (organization) NPI 1083779763 since 2006. The authorized official on file is Judith Tutin, President.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1083779763 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Psychogenesis, Inc. |
| Practice address | 519 BROAD ST, SUITE 202, Rome, GA, 30161 |
| Phone | 7062325544 |
| Fax | 8885431173 |
| Enumeration date | 2006-12-24 |
| Last updated in NPPES | 2015-12-03 |
Authorized official
| Name | Judith Tutin |
|---|---|
| Title | President |
| Phone | 7062325544 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 103TC0700X | Clinical Psychologist | Primary | 2075 | GA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000728923A | Medicaid | GA | — |
Copy-ready billing details
Provider: Psychogenesis, Inc. NPI: 1083779763 Taxonomy: 103TC0700X (Clinical Psychologist) Address: 519 BROAD ST, SUITE 202, Rome, GA, 30161
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1538155957 | Douglas Holstein | Individual | Certified Registered Nurse Anesthetist | Rome, GA |
| 1265597942 | Judith Tutin | Individual | Clinical Psychologist | Rome, GA |
Verify this record
Cross-check NPI 1083779763 against the authoritative CMS record: view Psychogenesis, Inc. on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Psychogenesis, Inc.?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2015-12-03.