| Professional Behavioral Health And Associates, Llc | |
|
245 Country Club Dr Bldg 300b Stockbridge GA 30281-7213 | |
| (678) 284-1008 | |
| (678) 284-1009 |
| Full Name | Professional Behavioral Health And Associates, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 245 Country Club Dr Bldg 300b, Stockbridge, Georgia |
| Authorized Official Name and Position | Christy Turley (OWNER) |
| Authorized Official Contact | 6782841008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Behavioral Health And Associates, Llc 245 Country Club Dr Bldg 300b Stockbridge GA 30281-7213 Ph: (678) 284-1008 | Professional Behavioral Health And Associates, Llc 245 Country Club Dr Bldg 300b Stockbridge GA 30281-7213 Ph: (678) 284-1008 |
| NPI Number | 1477014413 |
|---|---|
| Provider Enumeration Date | 03/30/2019 |
| Last Update Date | 03/30/2019 |
| Medicare PECOS PAC ID | 9537495429 |
|---|---|
| Medicare Enrollment ID | O20190730004656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477014413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Martin Thomas Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760784839 PECOS PAC ID: 7416190947 Enrollment ID: I20130830000269 |
| Provider Name | Natacha Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003298035 PECOS PAC ID: 6800143496 Enrollment ID: I20180730000442 |
| Provider Name | Myron Falkner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598196198 PECOS PAC ID: 6103059480 Enrollment ID: I20190613003359 |
| Provider Name | Stacey Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245794387 PECOS PAC ID: 1456786912 Enrollment ID: I20200111000041 |
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