Child And Family Psychotherapy Center | |
680 Douthit Ferry Rd Suite 106 Cartersville GA 30120-4150 | |
(770) 334-8461 | |
(770) 334-8624 |
Full Name | Child And Family Psychotherapy Center |
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Speciality | Psychologist |
Location | 680 Douthit Ferry Rd, Cartersville, Georgia |
Authorized Official Name and Position | Mary B Summerville (LICENSED PSYCHOLOGIST) |
Authorized Official Contact | 7703348461 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Child And Family Psychotherapy Center 680 Douthit Ferry Rd Suite 106 Cartersville GA 30120-4150 Ph: (770) 334-8461 | Child And Family Psychotherapy Center 680 Douthit Ferry Rd Suite 106 Cartersville GA 30120-4150 Ph: (770) 334-8461 |
NPI Number | 1356608459 |
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Provider Enumeration Date | 04/13/2012 |
Last Update Date | 04/13/2012 |
Identifier | Type | State | Issuer |
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1356608459 | NPI | - | NPPES |
000462294D | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PSY001432 (Georgia) | Primary |
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