| Dekalb Community Service Board | |
|
445 Winn Way Decatur GA 30030-1707 | |
| (404) 294-3836 | |
| Not Available |
| Full Name | Dekalb Community Service Board |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 445 Winn Way, Decatur, Georgia |
| Authorized Official Name and Position | Fabio Bruno Van Der Merwe (COO) |
| Authorized Official Contact | 4042943836 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dekalb Community Service Board 445 Winn Way Fl 4 Decatur GA 30030-1707 Ph: (404) 294-3836 | Dekalb Community Service Board 445 Winn Way Decatur GA 30030-1707 Ph: (404) 294-3836 |
| NPI Number | 1073686978 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 04/22/2020 |
| Certification Date | 04/22/2020 |
| Medicare PECOS PAC ID | 8527958487 |
|---|---|
| Medicare Enrollment ID | O20040316001099 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073686978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Lana M Chase |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1346441029 PECOS PAC ID: 1355232893 Enrollment ID: I20040323001282 |
| Provider Name | Jyothi N Mattam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306978929 PECOS PAC ID: 7214975663 Enrollment ID: I20050418000708 |
| Provider Name | Lynn Vanliew |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1003945098 PECOS PAC ID: 9931140647 Enrollment ID: I20050512000601 |
| Provider Name | Sophia L Henry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023110806 PECOS PAC ID: 5991707200 Enrollment ID: I20070215000014 |
| Provider Name | Monica Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346258795 PECOS PAC ID: 3678670866 Enrollment ID: I20070523000248 |
| Provider Name | William Schneider |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023273109 PECOS PAC ID: 3870651144 Enrollment ID: I20081015000627 |
| Provider Name | Margaret A Redus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609020007 PECOS PAC ID: 2860540770 Enrollment ID: I20090504000277 |
| Provider Name | Demaree L Trammel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255333068 PECOS PAC ID: 5991736316 Enrollment ID: I20090720000273 |
| Provider Name | Huey J Chen |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1144550641 PECOS PAC ID: 7315073335 Enrollment ID: I20100330000211 |
| Provider Name | Mridula Puri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316061492 PECOS PAC ID: 1254527211 Enrollment ID: I20101202000410 |
| Provider Name | Neesha A Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285838516 PECOS PAC ID: 4880877208 Enrollment ID: I20110323000222 |
| Provider Name | Shahina Mirza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891744090 PECOS PAC ID: 9537332689 Enrollment ID: I20111104000482 |
| Provider Name | Ann M Siegel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710008016 PECOS PAC ID: 6901071315 Enrollment ID: I20111214000342 |
| Provider Name | Athena H Sotus-nawar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902070162 PECOS PAC ID: 9739337817 Enrollment ID: I20120914000101 |
| Provider Name | Carmen Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023249059 PECOS PAC ID: 8022261643 Enrollment ID: I20130110000295 |
| Provider Name | Jamil Eman Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376882191 PECOS PAC ID: 3274778568 Enrollment ID: I20130313000553 |
| Provider Name | Jeff D Sanders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821124488 PECOS PAC ID: 9234370958 Enrollment ID: I20130723000618 |
| Provider Name | Sabo Uba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508106873 PECOS PAC ID: 4385889849 Enrollment ID: I20131030001535 |
| Provider Name | Joseph K Obuba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043630627 PECOS PAC ID: 6709002967 Enrollment ID: I20140723002167 |
| Provider Name | Naureen Munawar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245420082 PECOS PAC ID: 9931363413 Enrollment ID: I20150721002943 |
| Provider Name | Stacie Nevins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033589338 PECOS PAC ID: 3779884325 Enrollment ID: I20151224000072 |
| Provider Name | Cynthia Gillikin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922399203 PECOS PAC ID: 4688979164 Enrollment ID: I20160222000516 |
| Provider Name | Lynne Collier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093145088 PECOS PAC ID: 6800191263 Enrollment ID: I20160223000365 |
| Provider Name | Chikkanayaknhalli B Lokesh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023127222 PECOS PAC ID: 1153619044 Enrollment ID: I20161010000224 |
| Provider Name | Joshua M Hatcher-mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407398142 PECOS PAC ID: 3173803756 Enrollment ID: I20161219000821 |
| Provider Name | Adewumi T Adebomojo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558591248 PECOS PAC ID: 5991948374 Enrollment ID: I20170522001184 |
| Provider Name | Roxanne Claire Mcmorris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811255920 PECOS PAC ID: 6002190766 Enrollment ID: I20171207002588 |
| Provider Name | Stefan Michael Routt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881013696 PECOS PAC ID: 4587968946 Enrollment ID: I20180802002913 |
| Provider Name | Emily Hrabovsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740634831 PECOS PAC ID: 6800149030 Enrollment ID: I20181105002166 |
| Provider Name | Autumn Hierholzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053889766 PECOS PAC ID: 9032456363 Enrollment ID: I20190124002645 |
| Provider Name | Victoria Benard |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1306200852 PECOS PAC ID: 6608115605 Enrollment ID: I20190311000435 |
| Provider Name | Shashank K Jha |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1174800072 PECOS PAC ID: 7719153360 Enrollment ID: I20190418000412 |
| Provider Name | Maima Fortune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598240822 PECOS PAC ID: 1456693308 Enrollment ID: I20190425002003 |
| Provider Name | Okechukwu Nnaji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619459542 PECOS PAC ID: 4284967910 Enrollment ID: I20190611002737 |
| Provider Name | Ahmad Umair Janjua |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588027973 PECOS PAC ID: 4880942333 Enrollment ID: I20190904001190 |
| Provider Name | Ndidiamaka Nwaka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639487036 PECOS PAC ID: 4880994011 Enrollment ID: I20190920002775 |
| Provider Name | Sandra Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376750752 PECOS PAC ID: 0840460705 Enrollment ID: I20191010003108 |
| Provider Name | Joseph Pfeffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437709086 PECOS PAC ID: 4688007016 Enrollment ID: I20191125003174 |
| Provider Name | Kate O Aibangbee |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1134649031 PECOS PAC ID: 2365864923 Enrollment ID: I20200628000023 |
| Provider Name | Jessica Chang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114372455 PECOS PAC ID: 8426312729 Enrollment ID: I20200717002824 |
| Provider Name | Vera Tate |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750647384 PECOS PAC ID: 4183928278 Enrollment ID: I20201008002846 |
| Provider Name | Tyronjala Shontel Gainey-grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659615342 PECOS PAC ID: 5597185892 Enrollment ID: I20201102002049 |
| Provider Name | Kimberly Paige Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497244511 PECOS PAC ID: 1759792161 Enrollment ID: I20201116001261 |
| Provider Name | Diana Murray Woodall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427412139 PECOS PAC ID: 6608169172 Enrollment ID: I20201204001338 |
| Provider Name | Susan Blair Gause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164030953 PECOS PAC ID: 3577975341 Enrollment ID: I20201220000024 |
| Provider Name | Toyin O Adekunle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063073153 PECOS PAC ID: 9739594185 Enrollment ID: I20210216002780 |
| Provider Name | Domonic Jovan Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962821033 PECOS PAC ID: 1254636327 Enrollment ID: I20210916001418 |
| Provider Name | Lance Timothy Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033783998 PECOS PAC ID: 1658777362 Enrollment ID: I20220815002809 |
| Provider Name | Panrapee J Mahautmr |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1417302118 PECOS PAC ID: 5496163172 Enrollment ID: I20221115003007 |
| Provider Name | Vinoda Makam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114936671 PECOS PAC ID: 1850765058 Enrollment ID: I20230329000950 |
| Provider Name | Eric Michael Watts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619488293 PECOS PAC ID: 0941675193 Enrollment ID: I20230331001480 |
| Provider Name | Elizabeth Anne Genge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154988384 PECOS PAC ID: 4789059346 Enrollment ID: I20230412002558 |
| Provider Name | Eniola Oladokun-meroyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255067047 PECOS PAC ID: 7618342213 Enrollment ID: I20230413000984 |
| Provider Name | Lilian Chinyere Eneude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730871120 PECOS PAC ID: 7315305059 Enrollment ID: I20230628000587 |
| Provider Name | Carla Bourelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851688097 PECOS PAC ID: 1456713452 Enrollment ID: I20230808001258 |
| Provider Name | Paulina Jasmin Sidonie Kaiser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790246700 PECOS PAC ID: 0941538987 Enrollment ID: I20230913002945 |
| Provider Name | Stephen Cumbest |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346993565 PECOS PAC ID: 4880045665 Enrollment ID: I20240105000919 |
| Provider Name | Phyllis Zupkow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366684607 PECOS PAC ID: 7618328055 Enrollment ID: I20240110000476 |
| Provider Name | Shelby Cynthia Roche |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881068575 PECOS PAC ID: 0446601694 Enrollment ID: I20240111003721 |
| Provider Name | David Jordan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851765523 PECOS PAC ID: 0244681351 Enrollment ID: I20240112001138 |
| Provider Name | Mary L Locke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710513783 PECOS PAC ID: 8729439880 Enrollment ID: I20240112002815 |
| Provider Name | Jennifer Haines-pruitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962948687 PECOS PAC ID: 6406208461 Enrollment ID: I20240116002137 |
| Provider Name | Amy Martin Bond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902224892 PECOS PAC ID: 4385096841 Enrollment ID: I20240119002466 |
| Provider Name | Meagan Nicole Annis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073022075 PECOS PAC ID: 9133572670 Enrollment ID: I20240131002492 |
| Provider Name | Melissa Bradford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033832092 PECOS PAC ID: 2860835121 Enrollment ID: I20240205000224 |
| Provider Name | Donnisha M Lavigne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912483744 PECOS PAC ID: 5991148629 Enrollment ID: I20240208003928 |
| Provider Name | Richard Kyle Mccranie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376318808 PECOS PAC ID: 8022451715 Enrollment ID: I20240209001376 |
| Provider Name | Morgan Caseman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538744560 PECOS PAC ID: 4587008669 Enrollment ID: I20240216000960 |
| Provider Name | Vanessa Stewart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023327558 PECOS PAC ID: 8224473277 Enrollment ID: I20240229000682 |
| Provider Name | Andrew Leo Gray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932575016 PECOS PAC ID: 9436594165 Enrollment ID: I20240304001813 |
| Provider Name | Renee Atwood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407637473 PECOS PAC ID: 8729424239 Enrollment ID: I20240306003957 |
| Provider Name | Janel Allen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568910669 PECOS PAC ID: 7618314618 Enrollment ID: I20240326003966 |
| Provider Name | Diana Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932293081 PECOS PAC ID: 0042657058 Enrollment ID: I20240326004125 |
| Provider Name | Juliet Owusu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235780065 PECOS PAC ID: 2668810979 Enrollment ID: I20240405001315 |
| Provider Name | Aliyah Montgomery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043769557 PECOS PAC ID: 1951740042 Enrollment ID: I20240423001000 |
| Provider Name | Sora Judy Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376005090 PECOS PAC ID: 0648506360 Enrollment ID: I20240430001141 |
| Provider Name | Eleanor Mallory |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902669260 PECOS PAC ID: 6901247477 Enrollment ID: I20240515001057 |
Joseph T Elder, Psy.d., P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1439 Mclendon Dr Ste D, Decatur, GA 30033 Phone: 404-493-4381 Fax: 770-934-3280 | |
Haven House Counseling Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4650 Flat Shoals Pkwy, Decatur, GA 30034 Phone: 404-243-9336 Fax: 404-212-1265 | |
Sherri Cauthen, Lcsw, Rpt-s Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1924 Clairmont Rd Ste 105, Decatur, GA 30033 Phone: 770-743-7405 | |
Alliance Recovery Center, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 209 Swanton Way # B, Decatur, GA 30030 Phone: 404-377-7669 Fax: 404-377-8536 | |
Center For Cognitive Rehabilitation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1276 Mcconnell Dr, Suite C, Decatur, GA 30033 Phone: 404-321-1441 Fax: 404-321-5876 | |
Lissy Isaacson Lcsw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1123 Clairmont Road, Decatur, GA 30030 Phone: 912-844-0221 | |
Developmental Evaluation Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 440 Winn Way, Decatur, GA 30030 Phone: 404-508-6413 Fax: 404-508-6443 |