| Blueprint Interventions Group | |
|
611 Lakewater Estates Ln Stone Mountain GA 30087-4999 | |
| (404) 931-5738 | |
| (404) 882-6281 |
| Full Name | Blueprint Interventions Group |
|---|---|
| Speciality | Counselor |
| Location | 611 Lakewater Estates Ln, Stone Mountain, Georgia |
| Authorized Official Name and Position | Lakeya Nesbit-gaither (CEO) |
| Authorized Official Contact | 4049815248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blueprint Interventions Group Po Box 870603 Stone Mountain GA 30087-0016 Ph: (404) 931-5738 | Blueprint Interventions Group 611 Lakewater Estates Ln Stone Mountain GA 30087-4999 Ph: (404) 931-5738 |
| NPI Number | 1619746351 |
|---|---|
| Provider Enumeration Date | 12/21/2023 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Medicare PECOS PAC ID | 9830533108 |
|---|---|
| Medicare Enrollment ID | O20240215000884 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619746351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lakeya Nesbit-gaither |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881846913 PECOS PAC ID: 0749624013 Enrollment ID: I20240215001075 |
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