| Family Art Therapy Center Pc | |
|
109 Old Livery Street Clayton GA 30525 | |
| (706) 782-0717 | |
| (706) 782-5266 |
| Full Name | Family Art Therapy Center Pc |
|---|---|
| Speciality | Counselor |
| Location | 109 Old Livery Street, Clayton, Georgia |
| Authorized Official Name and Position | Christy Elizabeth Black (CEO) |
| Authorized Official Contact | 0649035357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Art Therapy Center Pc Po Box 1689 Clayton GA 30525-0043 Ph: (706) 782-0717 | Family Art Therapy Center Pc 109 Old Livery Street Clayton GA 30525 Ph: (706) 782-0717 |
| NPI Number | 1609916147 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 03/13/2023 |
| Certification Date | 03/09/2023 |
| Medicare PECOS PAC ID | 6406843408 |
|---|---|
| Medicare Enrollment ID | O20240304002412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609916147 | NPI | - | NPPES |
| 10045514 | Other | GA | CMO AMERIGROUP |
| 743776000 | Other | GA | CMO MAGELLAN |
| 052483465A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC 003219 (Georgia) | Primary |
| Provider Name | Christy Elizabeth Black |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346380946 PECOS PAC ID: 7618324641 Enrollment ID: I20240304002468 |
Family Art Therapy Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 44 Cottonwood St., Clayton, GA 30525 Phone: 706-782-0717 Fax: 706-782-5266 | |
Clayton Therapy Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Chechero St, Suite 2, Clayton, GA 30525 Phone: 706-782-6827 Fax: 706-782-0124 | |
Georgia Mountain Psychological Associates Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 851 Highway 441 S Ste 105, Clayton, GA 30525 Phone: 706-782-1237 Fax: 404-393-0737 | |
Robinson Counseling Resources Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 340 Smith St, Suite 2, Clayton, GA 30525 Phone: 706-782-9758 Fax: 706-782-9758 | |
Amanda Howard Pileski, Phd, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 851 Highway 441 S Ste 105, Clayton, GA 30525 Phone: 706-782-1237 Fax: 404-393-0737 | |
Esprit De Core Counseling, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 692 Prime Hill Dr, Clayton, GA 30525 Phone: 706-782-7194 |