| River Edge Behavioral Health Center | |
|
175 Emery Hwy Macon GA 31217-3692 | |
| (478) 751-4519 | |
| Not Available |
| Full Name | River Edge Behavioral Health Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 175 Emery Hwy, Macon, Georgia |
| Authorized Official Name and Position | Beth Tyler (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4787523231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Edge Behavioral Health Center 175 Emery Hwy Macon GA 31217-3692 Ph: (478) 751-4519 | River Edge Behavioral Health Center 175 Emery Hwy Macon GA 31217-3692 Ph: (478) 751-4519 |
| NPI Number | 1174512966 |
|---|---|
| Provider Enumeration Date | 10/14/2005 |
| Last Update Date | 05/05/2008 |
| Medicare PECOS PAC ID | 1153315874 |
|---|---|
| Medicare Enrollment ID | O20040414000303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174512966 | NPI | - | NPPES |
| 000604194E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jaymal R. Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962433599 PECOS PAC ID: 3779474010 Enrollment ID: I20040324000650 |
| Provider Name | Ginari G Price |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689676157 PECOS PAC ID: 9133149461 Enrollment ID: I20051201000731 |
| Provider Name | Richard L Elliott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558446559 PECOS PAC ID: 8628173853 Enrollment ID: I20070418000006 |
| Provider Name | Ana Zully Teran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851479356 PECOS PAC ID: 7012097082 Enrollment ID: I20080103000111 |
| Provider Name | Theresa Courtney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508877325 PECOS PAC ID: 1254479835 Enrollment ID: I20091119000409 |
| Provider Name | Louis A. Barton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467464438 PECOS PAC ID: 8022159987 Enrollment ID: I20100114000230 |
| Provider Name | Jacquelyn D. Owens |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1184845513 PECOS PAC ID: 9133393846 Enrollment ID: I20111115000465 |
| Provider Name | Sujatha K Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053408328 PECOS PAC ID: 2769640556 Enrollment ID: I20120224000564 |
| Provider Name | Victoria B Freeney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346503190 PECOS PAC ID: 9436314846 Enrollment ID: I20120710000762 |
| Provider Name | Foster Blake Brin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083701312 PECOS PAC ID: 8123334752 Enrollment ID: I20150827002065 |
| Provider Name | Virginia A Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548625114 PECOS PAC ID: 5597018333 Enrollment ID: I20181025000645 |
| Provider Name | Stephanie Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093206591 PECOS PAC ID: 1254662158 Enrollment ID: I20191008000139 |
| Provider Name | Salena Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396195301 PECOS PAC ID: 3779912076 Enrollment ID: I20200408001618 |
| Provider Name | Kenyotter Whipple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356755128 PECOS PAC ID: 1759710965 Enrollment ID: I20200408003520 |
| Provider Name | Angela Leigh Eubanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205468840 PECOS PAC ID: 7911338371 Enrollment ID: I20200519001660 |
| Provider Name | Ralph Ogwotu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144674581 PECOS PAC ID: 0749694008 Enrollment ID: I20210127002036 |
| Provider Name | Joshua David Minich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346514221 PECOS PAC ID: 1355755638 Enrollment ID: I20210127002779 |
Family Behavioral Care Of Central Ga, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3985 Arkwright Rd, Suite 102, Macon, GA 31210 Phone: 478-474-4265 Fax: 478-474-7863 | |
Ste. A Emery Hwy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 217a Emery Hwy, Macon, GA 31217 Phone: 478-751-4519 | |
Nancy Paulk Mobley Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 584 Arlington Pl, Macon, GA 31201 Phone: 478-743-1472 Fax: 478-743-1472 | |
Sleep Practitioners, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 275 Sheraton Blvd Ste 100, Macon, GA 31210 Phone: 478-745-5779 Fax: 478-742-7796 | |
Inner-connect Counseling, Consulting & Education Svc., Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2484 Ingleside Ave, Bldg. B, Ste. 102c, Macon, GA 31204 Phone: 478-361-0033 | |
Life Solutions Counseling Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 146 Pierce Ave, Macon, GA 31204 Phone: 478-796-2947 Fax: 478-210-2170 | |
The Psychiatric Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 567 Arlington Pl, Macon, GA 31201 Phone: 478-475-1299 |