| Community Mental Health Center Of Middle Georgia | |
|
2121a Bellevue Rd Dublin GA 31021-2998 | |
| (478) 272-1190 | |
| (478) 274-7628 |
| Full Name | Community Mental Health Center Of Middle Georgia |
|---|---|
| Speciality | Clinic/Center |
| Location | 2121a Bellevue Rd, Dublin, Georgia |
| Authorized Official Name and Position | Keith Moran (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4782721190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Mental Health Center Of Middle Georgia 2121a Bellevue Rd Dublin GA 31021-2998 Ph: (478) 272-1190 | Community Mental Health Center Of Middle Georgia 2121a Bellevue Rd Dublin GA 31021-2998 Ph: (478) 272-1190 |
| NPI Number | 1689657637 |
|---|---|
| Provider Enumeration Date | 11/23/2005 |
| Last Update Date | 01/12/2016 |
| Medicare PECOS PAC ID | 3173518644 |
|---|---|
| Medicare Enrollment ID | O20040415000940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689657637 | NPI | - | NPPES |
| 300030912A | Medicaid | GA | |
| 000606284H | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 007-R-0003 (Georgia) | Primary |
| Provider Name | Kalpana M Nayak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932126554 PECOS PAC ID: 5991773582 Enrollment ID: I20040921001209 |
| Provider Name | Edward C Lauterbach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306922315 PECOS PAC ID: 7416052584 Enrollment ID: I20070418000260 |
| Provider Name | Cynthia Q Mcwilliams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528043965 PECOS PAC ID: 3476638263 Enrollment ID: I20080304000267 |
| Provider Name | Jennifer Snowden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720067093 PECOS PAC ID: 6709956261 Enrollment ID: I20080610000511 |
| Provider Name | Sandra L Souza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043203839 PECOS PAC ID: 0042388225 Enrollment ID: I20081002000009 |
| Provider Name | Louis A. Barton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467464438 PECOS PAC ID: 8022159987 Enrollment ID: I20100114000230 |
| Provider Name | Robert D Shuman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700864105 PECOS PAC ID: 4082757471 Enrollment ID: I20100208000323 |
| Provider Name | Mark D Durden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518087907 PECOS PAC ID: 7416080494 Enrollment ID: I20100727000944 |
| Provider Name | Newton William Chism |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366482507 PECOS PAC ID: 0446445845 Enrollment ID: I20101111000227 |
| Provider Name | Lydia Lee Daley |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1245385855 PECOS PAC ID: 9638351604 Enrollment ID: I20110311000546 |
| Provider Name | Wesley Neal Seabolt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962664623 PECOS PAC ID: 3971787151 Enrollment ID: I20110413000165 |
| Provider Name | Thomas Rumble |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306823323 PECOS PAC ID: 7517124654 Enrollment ID: I20120201000770 |
| Provider Name | Robert D Shuman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811158363 PECOS PAC ID: 6507014651 Enrollment ID: I20120913000656 |
| Provider Name | Mary Lou Devaul-eshleman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104972025 PECOS PAC ID: 9234210964 Enrollment ID: I20130723000088 |
| Provider Name | Eusebio G Hernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184790503 PECOS PAC ID: 9335140193 Enrollment ID: I20140624001157 |
| Provider Name | Charles P Mccormick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215195342 PECOS PAC ID: 7911149711 Enrollment ID: I20140822001646 |
| Provider Name | Mary Hannah Mccormick |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1992971287 PECOS PAC ID: 5294957932 Enrollment ID: I20141112001429 |
| Provider Name | Jennifer A Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396129813 PECOS PAC ID: 2163711797 Enrollment ID: I20160520000122 |
| Provider Name | Jessica N Battle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700254364 PECOS PAC ID: 8022305721 Enrollment ID: I20160923000771 |
| Provider Name | Swaroop Reddy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235363581 PECOS PAC ID: 7416285119 Enrollment ID: I20190819003888 |
| Provider Name | Ashley M. Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336479658 PECOS PAC ID: 0244562239 Enrollment ID: I20191023003607 |
| Provider Name | Mary Ann Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710457247 PECOS PAC ID: 9133451057 Enrollment ID: I20191025002368 |
| Provider Name | Jenny L. Yancey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457684821 PECOS PAC ID: 2466874847 Enrollment ID: I20210408001983 |
Horizons Family Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 Holly Ridge Rd, Dublin, GA 31021 Phone: 478-272-7514 Fax: 478-274-1158 | |
C&e Youth Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Dewey St., Dublin, GA 31021 Phone: 478-508-0152 | |
North Jefferson St Annex Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 N Jefferson St, Dublin, GA 31021 Phone: 478-275-6800 | |
Csb Clubhouse Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1008 Hillcrest Pkwy, Dublin, GA 31021 Phone: 478-272-1190 Fax: 478-274-7628 | |
Joy Macthomas Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 508 Academy Ave, Dublin, GA 31021 Phone: 478-274-2425 | |
Csb Of Middle Georgia Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2121a Bellevue Rd, Dublin, GA 31021 Phone: 478-272-1190 Fax: 478-275-6649 | |
Lynns Counseling & Consulting Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 212 W Jackson St, Suite A, Dublin, GA 31021 Phone: 478-304-5233 |