| Gateway Behavioral Health Services | |
|
700 Coastal Village Drive Brunswick GA 31520 | |
| (912) 554-8510 | |
| (912) 264-5965 |
| Full Name | Gateway Behavioral Health Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 700 Coastal Village Drive, Brunswick, Georgia |
| Authorized Official Name and Position | Wendy Hughes (CFO) |
| Authorized Official Contact | 9125548410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Behavioral Health Services 700 Coastal Village Drive Suite 102 Brunswick GA 31520 Ph: (912) 554-8510 | Gateway Behavioral Health Services 700 Coastal Village Drive Brunswick GA 31520 Ph: (912) 554-8510 |
| NPI Number | 1558478214 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 09/23/2014 |
| Medicare PECOS PAC ID | 3173510237 |
|---|---|
| Medicare Enrollment ID | O20040429000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558478214 | NPI | - | NPPES |
| 300030904A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Ganiat M Ajayi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023170842 PECOS PAC ID: 1052386893 Enrollment ID: I20040826000676 |
| Provider Name | Chrissie Clure |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255413654 PECOS PAC ID: 1254397003 Enrollment ID: I20041203000629 |
| Provider Name | Leon A Hyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215026067 PECOS PAC ID: 4688616493 Enrollment ID: I20061218000390 |
| Provider Name | Edward M Drohan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518929223 PECOS PAC ID: 5092816447 Enrollment ID: I20070730000092 |
| Provider Name | Marlene Zetzer Shivers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801915871 PECOS PAC ID: 9931267861 Enrollment ID: I20081022000305 |
| Provider Name | Kayln T Lane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619154028 PECOS PAC ID: 1153489851 Enrollment ID: I20081024000350 |
| Provider Name | Edward C Parks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598704330 PECOS PAC ID: 0042362675 Enrollment ID: I20090713000530 |
| Provider Name | Kevin J Winders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275577520 PECOS PAC ID: 3173539954 Enrollment ID: I20100604000004 |
| Provider Name | David Deuser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427237015 PECOS PAC ID: 2961672381 Enrollment ID: I20110823000241 |
| Provider Name | Stacy Mullins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255613485 PECOS PAC ID: 3476713629 Enrollment ID: I20120326000194 |
| Provider Name | Marion E Alston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801166749 PECOS PAC ID: 2567623481 Enrollment ID: I20120419000456 |
| Provider Name | Krystle Leigh Graham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225268949 PECOS PAC ID: 4880844067 Enrollment ID: I20121024000484 |
| Provider Name | Sherri C. Kroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437309861 PECOS PAC ID: 9931346509 Enrollment ID: I20130520000367 |
| Provider Name | Erika Lea Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316214711 PECOS PAC ID: 8325274434 Enrollment ID: I20131120000854 |
| Provider Name | Stephanie R Chapman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124256714 PECOS PAC ID: 4082835046 Enrollment ID: I20141016002303 |
| Provider Name | Patricia N Watkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467486134 PECOS PAC ID: 5597812099 Enrollment ID: I20150420000611 |
| Provider Name | Edyn B Mckinnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235595604 PECOS PAC ID: 2163711961 Enrollment ID: I20160518001067 |
| Provider Name | Jesse Mckinnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407219314 PECOS PAC ID: 5698069953 Enrollment ID: I20160809001733 |
| Provider Name | Mandy Hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740425479 PECOS PAC ID: 5395030373 Enrollment ID: I20160830001798 |
| Provider Name | Dana Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043761331 PECOS PAC ID: 5597047522 Enrollment ID: I20170126001111 |
| Provider Name | Megan J Woolwine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184990392 PECOS PAC ID: 1456634278 Enrollment ID: I20170201001760 |
| Provider Name | Iris Hipchen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740733732 PECOS PAC ID: 6800179540 Enrollment ID: I20170203001173 |
| Provider Name | Alicia Thrift |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538604368 PECOS PAC ID: 0648555730 Enrollment ID: I20170403001718 |
| Provider Name | Ruby W Pontello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538162185 PECOS PAC ID: 7618061672 Enrollment ID: I20170908002956 |
| Provider Name | Karen E Brazell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689035032 PECOS PAC ID: 4789958364 Enrollment ID: I20170920002110 |
| Provider Name | Carlie L Tilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871953729 PECOS PAC ID: 4183988892 Enrollment ID: I20180504001486 |
| Provider Name | Jessica Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992218986 PECOS PAC ID: 0143584748 Enrollment ID: I20180508000687 |
| Provider Name | Sonya Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427561752 PECOS PAC ID: 6608125125 Enrollment ID: I20180816002268 |
| Provider Name | Peri M Kyriacos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215413158 PECOS PAC ID: 2567711559 Enrollment ID: I20180824000753 |
| Provider Name | Hadas Maimon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699193821 PECOS PAC ID: 3173876026 Enrollment ID: I20181023003727 |
| Provider Name | Gregory C Claxton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174087860 PECOS PAC ID: 9335472570 Enrollment ID: I20190604000215 |
| Provider Name | Grace Peralta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841760345 PECOS PAC ID: 7214260769 Enrollment ID: I20190614002165 |
| Provider Name | Leigh A Cundiff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841752326 PECOS PAC ID: 5597090076 Enrollment ID: I20190708000381 |
| Provider Name | Jared Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750769725 PECOS PAC ID: 6800127937 Enrollment ID: I20191003002828 |
| Provider Name | Yoshi T Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023670148 PECOS PAC ID: 5991137796 Enrollment ID: I20191116000323 |
| Provider Name | Emilie Taulbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720611379 PECOS PAC ID: 3678994019 Enrollment ID: I20200610002857 |
| Provider Name | Jay Synn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518026160 PECOS PAC ID: 2668417759 Enrollment ID: I20201112000358 |
| Provider Name | Paige Lindsay Marnell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619316163 PECOS PAC ID: 3971806621 Enrollment ID: I20210413000273 |
| Provider Name | Joseph Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922631670 PECOS PAC ID: 5496164642 Enrollment ID: I20210429001783 |
| Provider Name | Lisa Gauthier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972107944 PECOS PAC ID: 7618376914 Enrollment ID: I20210518002047 |
| Provider Name | Andrea M Fritschle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942386032 PECOS PAC ID: 0941385835 Enrollment ID: I20210614002320 |
| Provider Name | Eleanor Cowherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972178218 PECOS PAC ID: 4385047919 Enrollment ID: I20210720003100 |
| Provider Name | Alexandra L Dodd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902330277 PECOS PAC ID: 7012280506 Enrollment ID: I20210727002598 |
| Provider Name | Domonic Jovan Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962821033 PECOS PAC ID: 1254636327 Enrollment ID: I20210916001418 |
| Provider Name | Emily Aquadro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417418344 PECOS PAC ID: 6204169568 Enrollment ID: I20211227000285 |
| Provider Name | Nicole A Stallworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801292941 PECOS PAC ID: 3870967565 Enrollment ID: I20230320002999 |
| Provider Name | Yvonne Efeoghene Erusiafe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780145607 PECOS PAC ID: 6204178189 Enrollment ID: I20230407001250 |
| Provider Name | Nisha Ramchander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104455674 PECOS PAC ID: 1658701347 Enrollment ID: I20230428002506 |
| Provider Name | Daniel Perry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912429069 PECOS PAC ID: 5597120345 Enrollment ID: I20230429000176 |
| Provider Name | Mary Mercer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538796925 PECOS PAC ID: 9032549233 Enrollment ID: I20230501000370 |
| Provider Name | Johnathan Pierson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821526229 PECOS PAC ID: 5294077426 Enrollment ID: I20230501000707 |
| Provider Name | Zuleimye Valle Blas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306316906 PECOS PAC ID: 0143659805 Enrollment ID: I20230501000845 |
| Provider Name | Caitlyn D Fitzgerald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538781760 PECOS PAC ID: 4789006594 Enrollment ID: I20230501001717 |
| Provider Name | Sitwat F Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376004556 PECOS PAC ID: 4183967961 Enrollment ID: I20230501001897 |
| Provider Name | Modupeoluwa Omolola Babalola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619530888 PECOS PAC ID: 8426479387 Enrollment ID: I20230501002046 |
| Provider Name | Lorelys Arroyo Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114553120 PECOS PAC ID: 0244651149 Enrollment ID: I20230501002287 |
| Provider Name | Joseph Harwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154070068 PECOS PAC ID: 3971956046 Enrollment ID: I20240125002124 |
| Provider Name | Aleksandra Grabb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366182289 PECOS PAC ID: 9133572027 Enrollment ID: I20240126002506 |
| Provider Name | Carloyn Akin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245810142 PECOS PAC ID: 6608229521 Enrollment ID: I20240126003768 |
| Provider Name | Kaitlyn Halsema |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033790829 PECOS PAC ID: 9739524067 Enrollment ID: I20240227001357 |
| Provider Name | Luis Hernandez Cobian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417427063 PECOS PAC ID: 3971948225 Enrollment ID: I20240227001900 |
| Provider Name | Natalie Rivera Matos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295312791 PECOS PAC ID: 4789029927 Enrollment ID: I20240228000799 |
| Provider Name | Naomi Gunadeva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376172890 PECOS PAC ID: 5395175459 Enrollment ID: I20240228001038 |
Coastal Neurology And Neurosurgery Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Starling St, Suite 506, Brunswick, GA 31520 Phone: 912-264-9670 Fax: 912-264-9671 | |
Maria C. Coughenour Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2318 Heron St, Brunswick, GA 31520 Phone: 912-265-7660 Fax: 912-265-7858 | |
The Resiliency Institute, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 706 G St, Suite 101, Brunswick, GA 31520 Phone: 912-450-9700 | |
Jessica Poe P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3441 Cypress Mill Rd Ste 101, Brunswick, GA 31520 Phone: 912-275-4763 Fax: 912-216-3668 | |
Alina M Galliano Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 G St, Brunswick, GA 31520 Phone: 912-554-0811 Fax: 912-554-0763 | |
Radiant Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 513 Gloucester St, Brunswick, GA 31520 Phone: 912-580-9580 Fax: 912-289-9389 | |
Power For Living Enterprises, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Gloucester St Ste 202, Brunswick, GA 31520 Phone: 912-421-1001 Fax: 912-689-1054 |