Neurobehavioral Associates Llc | |
639 13th St Augusta GA 30901-1007 | |
(706) 823-5250 | |
(706) 823-5266 |
Full Name | Neurobehavioral Associates Llc |
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Speciality | Counselor |
Location | 639 13th St, Augusta, Georgia |
Authorized Official Name and Position | Jeremy B Hertza (EXEC CLINICAL DIRECTOR) |
Authorized Official Contact | 7068235266 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neurobehavioral Associates Llc 639 13th St Augusta GA 30901-1007 Ph: (706) 823-5250 | Neurobehavioral Associates Llc 639 13th St Augusta GA 30901-1007 Ph: (706) 823-5250 |
NPI Number | 1386059251 |
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Provider Enumeration Date | 06/30/2014 |
Last Update Date | 12/04/2015 |
Medicare PECOS PAC ID | 2769627660 |
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Medicare Enrollment ID | O20130325000524 |
Identifier | Type | State | Issuer |
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1386059251 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | APC004405 (Georgia) | Primary |
Provider Name | Jeremy B. Hertza |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1528237955 PECOS PAC ID: 2466528484 Enrollment ID: I20100121000067 |
Provider Name | Jessica Britt-thomas |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1770915399 PECOS PAC ID: 0749518744 Enrollment ID: I20190829001716 |
Provider Name | Shakeitrice Resheia Stokes |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1255693776 PECOS PAC ID: 3072845551 Enrollment ID: I20191216001945 |
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