Dr. Miranda Elise Colegrove, PsyD
Psychologist, Clinical Child & Adolescent in Atlanta, GA. Individual provider (NPI-1).
NPI number1497465744
StatusActive
Last updated in NPPESSep 10, 2026
Details
- NPI
- 1497465744
- Entity type
- Individual (NPI-1)
- Name
- Dr. Miranda Elise Colegrove
- Credential
- PsyD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 28, 2022
- Certification date
- Sep 10, 2026
- Last updated
- Sep 10, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC2200X | Psychologist, Clinical Child & Adolescent | – | – | Yes |
Practice location
2174 N Druid Hills Rd NeAtlanta, GA 30329-3102
Phone 404-785-3542
Mailing address
2993 Arbor ChaseDecatur, GA 30033-1800
Phone 979-583-8896
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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