| Peachford Behavioral Health System Of Atlanta | |
|
2151 Peachford Rd Atlanta GA 30338-6534 | |
| (770) 455-3200 | |
| (770) 454-2349 |
| Full Name | Peachford Behavioral Health System Of Atlanta |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2151 Peachford Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Steve Filton (SVP) |
| Authorized Official Contact | 8003477750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peachford Behavioral Health System Of Atlanta 367 S Gulph Rd Attn. Patti Jones King Of Prussia PA 19406-3121 Ph: (610) 768-3359 | Peachford Behavioral Health System Of Atlanta 2151 Peachford Rd Atlanta GA 30338-6534 Ph: (770) 455-3200 |
| NPI Number | 1124207220 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 03/27/2015 |
| Medicare PECOS PAC ID | 9234123894 |
|---|---|
| Medicare Enrollment ID | O20040414001376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124207220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 044-596 (Georgia) | Primary |
| Provider Name | Olujimi A Adefisan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790947216 PECOS PAC ID: 0143414318 Enrollment ID: I20101101001553 |
| Provider Name | Mhd A Alkhatib |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528115326 PECOS PAC ID: 6204927957 Enrollment ID: I20110801000544 |
| Provider Name | Naveed Ummed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841597770 PECOS PAC ID: 2567640519 Enrollment ID: I20110916000217 |
| Provider Name | Mark Craton Hutto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699844159 PECOS PAC ID: 1951575646 Enrollment ID: I20111115000204 |
| Provider Name | Angelica Betina Vazquez Anaya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750507794 PECOS PAC ID: 2668619420 Enrollment ID: I20130515000098 |
| Provider Name | Wendy D Barnes-mellstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982956454 PECOS PAC ID: 9234369828 Enrollment ID: I20140227000176 |
| Provider Name | Kimberly A Venable |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497711550 PECOS PAC ID: 5193748945 Enrollment ID: I20210503001267 |
| Provider Name | Danielle L Stembridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023689049 PECOS PAC ID: 3072904499 Enrollment ID: I20211220000830 |
| Provider Name | John C Leach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386902856 PECOS PAC ID: 2163748773 Enrollment ID: I20221027003306 |
| Provider Name | Shahnaz Mulla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013546662 PECOS PAC ID: 2860864113 Enrollment ID: I20230214002104 |
| Provider Name | Bridgette L Whiting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275266678 PECOS PAC ID: 8426423880 Enrollment ID: I20230417002546 |
| Provider Name | Valentina Asamaigor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598347106 PECOS PAC ID: 4284090564 Enrollment ID: I20230510003493 |
| Provider Name | Frank Vizen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942817648 PECOS PAC ID: 5395194849 Enrollment ID: I20231211000398 |
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