| Atlantic Counseling Services | |
|
132 Stephenson Ave Suite 100 Savannah GA 31405-5828 | |
| (912) 200-3195 | |
| (912) 349-7983 |
| Full Name | Atlantic Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 132 Stephenson Ave, Savannah, Georgia |
| Authorized Official Name and Position | Tommy Black (OWNER) |
| Authorized Official Contact | 9122003195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlantic Counseling Services 132 Stephenson Ave Suite 100 Savannah GA 31405-5828 Ph: (912) 200-3195 | Atlantic Counseling Services 132 Stephenson Ave Suite 100 Savannah GA 31405-5828 Ph: (912) 200-3195 |
| NPI Number | 1144578832 |
|---|---|
| Provider Enumeration Date | 08/28/2012 |
| Last Update Date | 01/17/2013 |
| Medicare PECOS PAC ID | 5991941767 |
|---|---|
| Medicare Enrollment ID | O20130424000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144578832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 003476 (Georgia) | Primary |
| Provider Name | Jennifer A Crumbley-dodson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669696282 PECOS PAC ID: 7315179678 Enrollment ID: I20140421000958 |
| Provider Name | Natasha Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477122034 PECOS PAC ID: 5698124808 Enrollment ID: I20231213003104 |
| Provider Name | Teresa Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407594948 PECOS PAC ID: 3072952928 Enrollment ID: I20240411004346 |
| Provider Name | Cory Lee Nietzke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962832550 PECOS PAC ID: 0345689832 Enrollment ID: I20240417000343 |
| Provider Name | Jason Anthony Nietzke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033521687 PECOS PAC ID: 2365883949 Enrollment ID: I20240514001726 |
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