| Lake Country Behavioral Health Clinic | |
|
931 N Jefferson St Ne Milledgeville GA 31061-2930 | |
| (678) 677-3782 | |
| Not Available |
| Full Name | Lake Country Behavioral Health Clinic |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 931 N Jefferson St Ne, Milledgeville, Georgia |
| Authorized Official Name and Position | Huzaifa Abukari Seidu (MD) |
| Authorized Official Contact | 6786773782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Country Behavioral Health Clinic 1557 Whitfield St Se Smyrna GA 30080-2270 Ph: (678) 677-3782 | Lake Country Behavioral Health Clinic 931 N Jefferson St Ne Milledgeville GA 31061-2930 Ph: (678) 677-3782 |
| NPI Number | 1699478552 |
|---|---|
| Provider Enumeration Date | 03/22/2023 |
| Last Update Date | 08/01/2024 |
| Certification Date | 08/01/2024 |
| Medicare PECOS PAC ID | 4587015409 |
|---|---|
| Medicare Enrollment ID | O20240209003058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699478552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Huzaifa Abukari Seidu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548497324 PECOS PAC ID: 0749445104 Enrollment ID: I20120710000258 |
| Provider Name | Beverly Ann Criss |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033996343 PECOS PAC ID: 1951747062 Enrollment ID: I20240312001711 |
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