Kevin Mark Johnson, | |
1170 Cleveland Ave, East Point, GA 30344-3615 | |
(404) 466-1249 | |
Not Available |
Full Name | Kevin Mark Johnson |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 4 Years |
Location | 1170 Cleveland Ave, East Point, Georgia |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508515917 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YS0200X | Counselor - School | (* (Not Available)) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Wellstar Cobb Hospital | Austell, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Wellstar Medical Group, Llc | 6709065402 | 1917 |
Entity Name | Wellstar Medical Group, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
Mailing Address | Practice Location Address |
---|---|
Kevin Mark Johnson, 106 Cherry Hill Ln, Stockbridge, GA 30281-7359 Ph: (770) 789-8956 | Kevin Mark Johnson, 1170 Cleveland Ave, East Point, GA 30344-3615 Ph: (404) 466-1249 |
Mrs. Ebonny Mills, LPC, NCC, MAC Counselor Medicare: Medicare Enrolled Practice Location: 3465 N Desert Dr Ste 104, East Point, GA 30344 Phone: 404-228-6650 | |
Alicia M. Mercer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3645 Marketplace Blvd, Ste 130-626, East Point, GA 30344 Phone: 404-558-6758 Fax: 404-600-6694 | |
Cierra Nicole Chaney, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2538 Stone Rd, East Point, GA 30344 Phone: 404-635-6021 Fax: 404-487-5880 | |
Miss Barbara Johnae Moorer, MA, CADCII, ICADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2872 Church St, East Point, GA 30344 Phone: 404-310-1133 Fax: 888-830-5578 | |
Laresha Foster, M.A., L.M.S.W., CAMS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1100 Cleveland Ave, East Point, GA 30344 Phone: 404-564-7063 | |
Candace Avril Richardson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1930 Taylor Ave, East Point, GA 30344 Phone: 781-330-1861 | |
Betty B Williams, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1636 Connally Dr, East Point, GA 30344 Phone: 404-762-4042 |