| Guiding Light Healthcare Services, Llc | |
|
124 Hospital Dr Warner Robins GA 31088-4204 | |
| (478) 449-8800 | |
| (478) 225-6504 |
| Full Name | Guiding Light Healthcare Services, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 124 Hospital Dr, Warner Robins, Georgia |
| Authorized Official Name and Position | Donald Shorter (CEO) |
| Authorized Official Contact | 4784498800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guiding Light Healthcare Services, Llc 124 Hospital Dr Warner Robins GA 31088-4204 Ph: (478) 449-8800 | Guiding Light Healthcare Services, Llc 124 Hospital Dr Warner Robins GA 31088-4204 Ph: (478) 449-8800 |
| NPI Number | 1841707668 |
|---|---|
| Provider Enumeration Date | 01/02/2018 |
| Last Update Date | 01/12/2023 |
| Certification Date | 01/12/2023 |
| Medicare PECOS PAC ID | 6800142175 |
|---|---|
| Medicare Enrollment ID | O20180629001300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841707668 | NPI | - | NPPES |
| 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 | Martin Thomas Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760784839 PECOS PAC ID: 7416190947 Enrollment ID: I20130830000269 |
| Provider Name | Charmaine Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083870265 PECOS PAC ID: 1355572611 Enrollment ID: I20140331000075 |
| Provider Name | Nurul I Hoque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912109505 PECOS PAC ID: 2163597170 Enrollment ID: I20150708000183 |
| Provider Name | Kishore J. Thampy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659367951 PECOS PAC ID: 0143268904 Enrollment ID: I20160919001614 |
| Provider Name | Ralph Ogwotu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144674581 PECOS PAC ID: 0749694008 Enrollment ID: I20210127002036 |
| Provider Name | Sheletta V Slough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154092161 PECOS PAC ID: 0941642318 Enrollment ID: I20240530002582 |
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