| Populations And Interventions Team Company | |
|
3182 Berthas Overlook Douglasville GA 30135-8458 | |
| (678) 310-9707 | |
| (470) 875-0083 |
| Full Name | Populations And Interventions Team Company |
|---|---|
| Speciality | Psychologist |
| Location | 3182 Berthas Overlook, Douglasville, Georgia |
| Authorized Official Name and Position | Mercedes Merritt Williams (CEO/OWNER) |
| Authorized Official Contact | 6783109707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Populations And Interventions Team Company 3182 Berthas Overlook Douglasville GA 30135-8458 Ph: (678) 310-9707 | Populations And Interventions Team Company 3182 Berthas Overlook Douglasville GA 30135-8458 Ph: (678) 310-9707 |
| NPI Number | 1730608522 |
|---|---|
| Provider Enumeration Date | 09/13/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7113293960 |
|---|---|
| Medicare Enrollment ID | O20180430000730 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730608522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0004X | Psychologist - Health | 40044 (California) | Primary |
| 405300000X | Prevention Professional | 28315 (Indiana) | Secondary |
| Provider Name | Russell E Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194769257 PECOS PAC ID: 5496640120 Enrollment ID: I20050318000751 |
| Provider Name | Mercedes Merritt Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952820086 PECOS PAC ID: 5294001046 Enrollment ID: I20180430001192 |
| Provider Name | Janet Salimonu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659892727 PECOS PAC ID: 7416280748 Enrollment ID: I20190531000811 |
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