| Susan K Kauffman Lmhc Pllc | |
|
146 Depot St Ste 202 Blue Ridge GA 30513-8503 | |
| (941) 780-4192 | |
| Not Available |
| Full Name | Susan K Kauffman Lmhc Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 146 Depot St Ste 202, Blue Ridge, Georgia |
| Authorized Official Name and Position | Susan K Kauffman (OWNER) |
| Authorized Official Contact | 9417804192 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan K Kauffman Lmhc Pllc Po Box 1157 Mc Caysville GA 30555-1157 Ph: (941) 780-4192 | Susan K Kauffman Lmhc Pllc 146 Depot St Ste 202 Blue Ridge GA 30513-8503 Ph: (941) 780-4192 |
| NPI Number | 1346521481 |
|---|---|
| Provider Enumeration Date | 09/02/2011 |
| Last Update Date | 07/09/2022 |
| Certification Date | 07/09/2022 |
| Medicare PECOS PAC ID | 9830574680 |
|---|---|
| Medicare Enrollment ID | O20220915001511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346521481 | NPI | - | NPPES |
| 003217124B | Medicaid | GA | |
| 003266024A | Medicaid | GA |
| Provider Name | Alvin Seifert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689712119 PECOS PAC ID: 2264621283 Enrollment ID: I20200305002728 |
| Provider Name | Benjamin Robert Crawford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215166871 PECOS PAC ID: 7113173980 Enrollment ID: I20220610000819 |
| Provider Name | Lance Timothy Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033783998 PECOS PAC ID: 1658777362 Enrollment ID: I20220815002809 |
| Provider Name | Michael Newberry |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1467569889 PECOS PAC ID: 6507929981 Enrollment ID: I20230110003215 |
| Provider Name | Solomon Gezahgn Abebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003526898 PECOS PAC ID: 5395100119 Enrollment ID: I20230525001951 |
| Provider Name | Susan K Kauffman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205820198 PECOS PAC ID: 2567847312 Enrollment ID: I20240206001404 |
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