| Tanner Medical Center Carrollton Bh | |
|
101 Doctors Dr Carrollton GA 30117-4486 | |
| (770) 836-9697 | |
| (770) 836-9897 |
| Full Name | Tanner Medical Center Carrollton Bh |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 101 Doctors Dr, Carrollton, Georgia |
| Authorized Official Name and Position | Carol S. Crews (CFO) |
| Authorized Official Contact | 7708129745 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanner Medical Center Carrollton Bh 109 Cedar St Ste C Carrollton GA 30117-2667 Ph: (770) 812-5770 | Tanner Medical Center Carrollton Bh 101 Doctors Dr Carrollton GA 30117-4486 Ph: (770) 836-9697 |
| NPI Number | 1871502260 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Medicare PECOS PAC ID | 2769387539 |
|---|---|
| Medicare Enrollment ID | O20150929001447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871502260 | NPI | - | NPPES |
| 300027104A | Other | GA | MEDICAID PAYEE IDENTIFICATION NUMBER |
| 296667723A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | NOT REQUIRED (Georgia) | Secondary |
| 251S00000X | Community/behavioral Health | 022-426 (Georgia) | Primary |
Response And Prevention Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 173 Kilgore Rd Ste 206, Carrollton, GA 30116 Phone: 770-653-5974 Fax: 678-890-1099 | |
David P. Hartley,m.d., P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 E Center St, Carrollton, GA 30117 Phone: 770-830-6006 Fax: 770-830-8322 | |
Carpe Diem Intellectus Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 208 Corporate Dr, Carrollton, GA 30117 Phone: 833-322-3423 Fax: 678-359-9897 | |
Lauri Shedd Therapy Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1325 S Park St # 1003, Carrollton, GA 30117 Phone: 314-882-0282 Fax: 470-870-8544 | |
Authentic Spirit Counseling Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2032 Maple St, Carrollton, GA 30117 Phone: 678-890-6127 | |
Ama Therapy & Co., Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 Newnan St, Carrollton, GA 30117 Phone: 678-796-8588 Fax: 678-664-9107 | |
Waves Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2717 N Highway 27, Carrollton, GA 30117 Phone: 470-244-2574 Fax: 678-890-1518 |