| Peaceway Counseling & Mediation Services Inc. | |
|
2405 Bemiss Rd Valdosta GA 31602-1936 | |
| (229) 333-2351 | |
| (229) 333-2353 |
| Full Name | Peaceway Counseling & Mediation Services Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2405 Bemiss Rd, Valdosta, Georgia |
| Authorized Official Name and Position | F. Tirrell Andrews (PROGRAM DIRECTOR) |
| Authorized Official Contact | 2293332351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peaceway Counseling & Mediation Services Inc. 2405 Bemiss Rd Valdosta GA 31602-1936 Ph: (229) 333-2351 | Peaceway Counseling & Mediation Services Inc. 2405 Bemiss Rd Valdosta GA 31602-1936 Ph: (229) 333-2351 |
| NPI Number | 1215113675 |
|---|---|
| Provider Enumeration Date | 01/16/2008 |
| Last Update Date | 01/16/2008 |
| Medicare PECOS PAC ID | 2062776255 |
|---|---|
| Medicare Enrollment ID | O20180516002277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215113675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | MFT001051 (Georgia) | Primary |
| Provider Name | Calvin Whitehead |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134327927 PECOS PAC ID: 0648355008 Enrollment ID: I20110523000323 |
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