Nathaniel Tucker Braddy, LPC | |
3633 Wheeler Rd Ste 365, Augusta, GA 30909-6549 | |
(706) 432-6866 | |
Not Available |
Full Name | Nathaniel Tucker Braddy |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 3633 Wheeler Rd Ste 365, Augusta, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306420583 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Secondary |
101YP2500X | Counselor - Professional | LPC014354 (Georgia) | Primary |
Entity Name | Personal Recovery Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20120110000096 |
Mailing Address | Practice Location Address |
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Nathaniel Tucker Braddy, LPC 3633 Wheeler Rd Ste 365, Augusta, GA 30909-6549 Ph: (706) 432-6866 | Nathaniel Tucker Braddy, LPC 3633 Wheeler Rd Ste 365, Augusta, GA 30909-6549 Ph: (706) 432-6866 |
Whitney O'connor, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1232 Hickman Rd, Augusta, GA 30904 Phone: 678-414-4596 | |
Danny Robinson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2609 Commons Boulevard, Augusta, GA 30909 Phone: 706-843-6242 | |
Ms. Jaime Penn, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2226 Acapulco Dr Apt C, Augusta, GA 30906 Phone: 706-750-9442 | |
Monifa Mccarther, Counselor Medicare: Medicare Enrolled Practice Location: 2101 Central Ave, Augusta, GA 30904 Phone: 706-750-2809 Fax: 706-868-5023 | |
Mr. Robert Derek Yosen, CAC2 Counselor Medicare: Not Enrolled in Medicare Practice Location: 2357 Tobacco Rd, Augusta, GA 30906 Phone: 706-722-3855 Fax: 706-798-3795 | |
Jennifer Diane Watson, APC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3421 Mike Padgett Hwy, Augusta, GA 30906 Phone: 706-432-7893 Fax: 706-432-3780 | |
Ms. Stephanie D Grant, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 3540 Wheeler Rd, Suite 619, Augusta, GA 30909 Phone: 706-733-0333 Fax: 706-733-0313 |