Amanda Holloway, | |
150 Medical Way, Riverdale, GA 30274-2533 | |
(404) 709-8373 | |
Not Available |
Full Name | Amanda Holloway |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 150 Medical Way, Riverdale, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114385598 | NPI | - | NPPES |
13678783 | Other | GA | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC008361 (Georgia) | Primary |
Entity Name | Positive Impact Health Centers, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790861995 PECOS PAC ID: 5496721987 Enrollment ID: O20040907000653 |
Mailing Address | Practice Location Address |
---|---|
Amanda Holloway, 150 Medical Way, Riverdale, GA 30274-2533 Ph: (404) 709-8373 | Amanda Holloway, 150 Medical Way, Riverdale, GA 30274-2533 Ph: (404) 709-8373 |
Carrie B Savage, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 223 Medical Center Dr, Riverdale, GA 30274 Phone: 770-766-7006 | |
Robyn Kelly Goodart, Counselor Medicare: Not Enrolled in Medicare Practice Location: 277 Medical Way, Riverdale, GA 30274 Phone: 470-298-7236 | |
Shontiaya S. Patterson, FNP Counselor Medicare: Medicare Enrolled Practice Location: 1324 Highway 138 Sw, Riverdale, GA 30296 Phone: 770-907-4949 Fax: 770-907-4022 | |
Gabrielle Rene Waters, MS, LPC Counselor Medicare: Medicare Enrolled Practice Location: 136 Highway 138 Sw Ste 400, Riverdale, GA 30274 Phone: 470-269-0190 | |
Luciana Renea Wright, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6373 Bell Haven Ln, Riverdale, GA 30296 Phone: 478-998-9531 | |
Ylonda N Hadley, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8455 Highway 85, Bldg 200 Suite A3, Riverdale, GA 30274 Phone: 678-778-9567 Fax: 678-817-3961 |