Ms Diamesha Walton, | |
84 Old Macedonia Rd, Manchester, GA 31816-1360 | |
(706) 845-4054 | |
(708) 845-4430 |
Full Name | Ms Diamesha Walton |
---|---|
Gender | Female |
Speciality | Counselor - Mental Health |
Location | 84 Old Macedonia Rd, Manchester, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215350368 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Mcintosh Trail Community Service Board |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336317270 PECOS PAC ID: 6204818669 Enrollment ID: O20040601001239 |
Mailing Address | Practice Location Address |
---|---|
Ms Diamesha Walton, 122 Gordon Commercial Dr Ste D, Lagrange, GA 30240-5754 Ph: (706) 845-4054 | Ms Diamesha Walton, 84 Old Macedonia Rd, Manchester, GA 31816-1360 Ph: (706) 845-4054 |
Leslie H Parks, NCC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 25b E Main St, Manchester, GA 31816 Phone: 706-366-2293 | |
Dr. Michele Stanford, PCS Counselor Medicare: Not Enrolled in Medicare Practice Location: 176 Gilbert Rd, Manchester, GA 31816 Phone: 706-975-0079 Fax: 706-441-0043 | |
Dr. Adonis Bray, Counselor Medicare: Not Enrolled in Medicare Practice Location: 907 Ira Parks Way, Manchester, GA 31816 Phone: 239-257-4961 |