| Menda Behavioral Health Services Pc | |
|
1303 Pendleton St Se Atlanta GA 30316-3801 | |
| (323) 776-3632 | |
| Not Available |
| Full Name | Menda Behavioral Health Services Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1303 Pendleton St Se, Atlanta, Georgia |
| Authorized Official Name and Position | Leslie Aria (PRESIDENT) |
| Authorized Official Contact | 9166071297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Menda Behavioral Health Services Pc 1303 Pendleton St Se Atlanta GA 30316-3801 Ph: () - | Menda Behavioral Health Services Pc 1303 Pendleton St Se Atlanta GA 30316-3801 Ph: (323) 776-3632 |
| NPI Number | 1326813387 |
|---|---|
| Provider Enumeration Date | 11/20/2023 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/18/2024 |
| Medicare PECOS PAC ID | 8022456854 |
|---|---|
| Medicare Enrollment ID | O20240329000641 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326813387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Angela Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821577107 PECOS PAC ID: 2668850579 Enrollment ID: I20240329001747 |
| Provider Name | Kimberly Bridi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730746009 PECOS PAC ID: 3678914900 Enrollment ID: I20240516003585 |
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