DR. ZACHARY TABER (PH.D.) – Counseling Psychologist, NPI 1174216089

DR. ZACHARY TABER (PH.D.) is a healthcare provider. based in Atlanta, Georgia. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PSY004644 (GA). The NPI Number for DR. ZACHARY TABER (PH.D.) is 1174216089

Main info

Male
Sole Proprietor
5 Years Of Experience
Name
DR. ZACHARY TABER (PH.D.)
NPI
1174216089
Phone
(631) 805-6693
Address
554 ELBRIDGE DR NW
Enumeration Date
29 May 2023
Last Update Date
29 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6783693235
Graduation Year
2021 (5 years ago)
PAC ID
6002337276
Professional Enrollment ID
I20250304001998
Address ID
GA303064216AT1074XNEXX600
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:3State licenses:1Digital endpointsOther names

483 CLINICAL PSYCHOLOGIST in GA

Provider Addresses for DR. ZACHARY TABER (PH.D.)

  • 554 ELBRIDGE DR NW

    ATLANTA, GA 303188148

    Phone: (631) 805-6693

    Type: Mailing

  • 1074 PONCE DE LEON AVE NE

    ATLANTA, GA 303064216

    Phone: (678) 369-3235

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250304001998IClinical PsychologistGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30318)

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Reviews

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Frequently asked questions

What identifier follows DR. ZACHARY TABER (PH.D.) across health systems?
The NPI 1174216089 uniquely identifies DR. ZACHARY TABER (PH.D.) in U.S. healthcare data.
Should I treat DR. ZACHARY TABER (PH.D.) as an active provider?
Patients and plans typically see DR. ZACHARY TABER (PH.D.) as active in the national extract.
What services align with DR. ZACHARY TABER (PH.D.)'s listing?
DR. ZACHARY TABER (PH.D.)'s public classification highlights Counseling Psychologist. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. ZACHARY TABER (PH.D.)?
DR. ZACHARY TABER (PH.D.) shows a connection to Atlanta, Georgia in registry-derived data.
Why is information missing for DR. ZACHARY TABER (PH.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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