| Behavioral Learned Management Llc | |
|
620 Nicholas Ln Macon GA 31216-7383 | |
| (478) 731-2087 | |
| Not Available |
| Full Name | Behavioral Learned Management Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 620 Nicholas Ln, Macon, Georgia |
| Authorized Official Name and Position | Terrell Dameon Smith (OWNER) |
| Authorized Official Contact | 4787312087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Learned Management Llc 620 Nicholas Ln Macon GA 31216-7383 Ph: (478) 731-2087 | Behavioral Learned Management Llc 620 Nicholas Ln Macon GA 31216-7383 Ph: (478) 731-2087 |
| NPI Number | 1225763162 |
|---|---|
| Provider Enumeration Date | 07/22/2022 |
| Last Update Date | 07/22/2022 |
| Certification Date | 07/22/2022 |
| Medicare PECOS PAC ID | 3274919329 |
|---|---|
| Medicare Enrollment ID | O20220927004087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225763162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Terrell Dameon Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497344477 PECOS PAC ID: 4183000235 Enrollment ID: I20220927004092 |
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