OrganizationActive
Southside Psychiatric Consultants LLC
NPI 1902670490 · Psychiatric/Mental Health Nurse Practitioner · Riverdale, GA
Provider details
- NPI number
- 1902670490
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Ralph Ogwotu, Business Owner(404) 734-4445
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Community/Behavioral Health Agency251S00000X
Agencies
Ambulatory Health Care Facilities
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6572 River Park Dr Ste 101g
Riverdale, GA 30274-2214
Phone: (404) 734-4445
Fax: (404) 745-0552
Street-level locationGet directions
Mailing address
110 W Pier Way
Fayetteville, GA 30214-4617
Other names (DBA / former)
- Doing business as
- Business Owner
Registry dates
- Enumerated
- 2023-11-14
- Last updated
- 2025-06-17
- Certified
- 2025-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.