Mrs Jordan Lyndsey Child, LMFT | |
321b Greenville Street, Lagrange, GA 30241-3231 | |
(706) 887-5787 | |
(706) 780-5402 |
Full Name | Mrs Jordan Lyndsey Child |
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Gender | Female |
Speciality | Marriage & Family Therapist |
Location | 321b Greenville Street, Lagrange, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558753889 | NPI | - | NPPES |
003202428I | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | MFT001596 (Georgia) | Primary |
Entity Name | Behavioral Health Professionals Of Lagrange, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861016537 PECOS PAC ID: 3779982079 Enrollment ID: O20210518002170 |
Mailing Address | Practice Location Address |
---|---|
Mrs Jordan Lyndsey Child, LMFT 321b Greenville Street, Lagrange, GA 30241-3231 Ph: (706) 887-5787 | Mrs Jordan Lyndsey Child, LMFT 321b Greenville Street, Lagrange, GA 30241-3231 Ph: (706) 887-5787 |
Shawn Allen Droge, S/T Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 122 Gordon Commercial Dr, Suite D, Lagrange, GA 30240 Phone: 706-845-4054 Fax: 706-845-4054 | |
Mr. Leslie Van Toole, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 321 Greenville St, Suite A, Lagrange, GA 30241 Phone: 706-884-0987 Fax: 706-884-9696 |