The Samaritan Counseling Center Of Southwest Georgia | |
208 S Broad St Bainbridge GA 39817-3616 | |
(229) 243-1633 | |
(229) 243-9446 |
Full Name | The Samaritan Counseling Center Of Southwest Georgia |
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Speciality | Counselor |
Location | 208 S Broad St, Bainbridge, Georgia |
Authorized Official Name and Position | Chris Beam (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2292431633 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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The Samaritan Counseling Center Of Southwest Georgia Po Box 1276 Bainbridge GA 39818-1276 Ph: (229) 243-1633 | The Samaritan Counseling Center Of Southwest Georgia 208 S Broad St Bainbridge GA 39817-3616 Ph: (229) 243-1633 |
NPI Number | 1669651212 |
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Provider Enumeration Date | 10/31/2007 |
Last Update Date | 02/26/2024 |
Certification Date | 02/26/2024 |
Medicare PECOS PAC ID | 1557628336 |
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Medicare Enrollment ID | O20171204000887 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669651212 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC004327 (Georgia) | Primary |
Provider Name | Chris A Beam |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1770608952 PECOS PAC ID: 6002173887 Enrollment ID: I20240309000214 |
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