Abby Wallace, LAPC | |
1875 Fant Dr, Fort Oglethorpe, GA 30742-3307 | |
(706) 806-1169 | |
(706) 806-1186 |
Full Name | Abby Wallace |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 1875 Fant Dr, Fort Oglethorpe, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376897694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | APC003548 (Georgia) | Primary |
Entity Name | The Transformation Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518117597 PECOS PAC ID: 6800137209 Enrollment ID: O20210805003112 |
Mailing Address | Practice Location Address |
---|---|
Abby Wallace, LAPC 1875 Fant Dr, Fort Oglethorpe, GA 30742-3307 Ph: (706) 806-1169 | Abby Wallace, LAPC 1875 Fant Dr, Fort Oglethorpe, GA 30742-3307 Ph: (706) 806-1169 |
Josh Henderson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 700 City Hall Dr, Fort Oglethorpe, GA 30742 Phone: 423-364-3460 Fax: 706-638-5541 | |
Brian Ezra Bates, CADC-I Counselor Medicare: Not Enrolled in Medicare Practice Location: 2007 Old Lafayette Rd, Fort Oglethorpe, GA 30742 Phone: 706-861-9390 Fax: 706-866-4740 | |
Mat Taylor Young, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2007 Old Lafayette Rd, Fort Oglethorpe, GA 30742 Phone: 706-861-9390 Fax: 706-866-4740 | |
Danielle Brown, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2007 Old Lafayette Rd, Fort Oglethorpe, GA 30742 Phone: 706-861-9390 | |
Mrs. Kimberly Lynn Sheppard, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1456 Battlefield Pkwy, Suite 5e, Fort Oglethorpe, GA 30742 Phone: 423-313-2060 Fax: 423-629-6967 | |
Loula Bett Pittman, M.ED., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1875 Fant Dr, Fort Oglethorpe, GA 30742 Phone: 706-806-1202 | |
Starlan James Childers, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2007 Old Lafayette Rd, Fort Oglethorpe, GA 30742 Phone: 706-861-9390 |