| Courageous Intentions, Llc | |
|
53 Pomona Circle Savannah GA 31419-8190 | |
| (423) 802-8115 | |
| Not Available |
| Full Name | Courageous Intentions, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 53 Pomona Circle, Savannah, Georgia |
| Authorized Official Name and Position | Mary Little (OWNER) |
| Authorized Official Contact | 9126288397 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Courageous Intentions, Llc 53 Pomona Cir Savannah GA 31419-8190 Ph: (912) 628-8397 | Courageous Intentions, Llc 53 Pomona Circle Savannah GA 31419-8190 Ph: (423) 802-8115 |
| NPI Number | 1659004299 |
|---|---|
| Provider Enumeration Date | 07/01/2022 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Medicare PECOS PAC ID | 2163882226 |
|---|---|
| Medicare Enrollment ID | O20230720002491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659004299 | NPI | - | NPPES |
| 1326487034 | Other | CO | NPI |
| 1326487034 | Other | GA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mary Little |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326487034 PECOS PAC ID: 0345575973 Enrollment ID: I20211209000236 |
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