The Eupatheia Center Inc | |
664 Scranton Rd Ste 201 Brunswick GA 31520-1947 | |
(912) 285-1610 | |
(912) 285-2595 |
Full Name | The Eupatheia Center Inc |
---|---|
Speciality | Psychologist |
Location | 664 Scranton Rd Ste 201, Brunswick, Georgia |
Authorized Official Name and Position | Brendan Clark Engen (PRESIDENT/CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 9128160076 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
The Eupatheia Center Inc 664 Scranton Rd Ste 201 Brunswick GA 31520-1947 Ph: (912) 285-1610 | The Eupatheia Center Inc 664 Scranton Rd Ste 201 Brunswick GA 31520-1947 Ph: (912) 285-1610 |
NPI Number | 1306010954 |
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Provider Enumeration Date | 04/15/2008 |
Last Update Date | 05/25/2022 |
Certification Date | 05/25/2022 |
Medicare PECOS PAC ID | 6507920675 |
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Medicare Enrollment ID | O20090204000511 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306010954 | NPI | - | NPPES |
10032838 | Other | GA | AMERIGROUP |
524588165A | Medicaid | GA | |
000577585G | Medicaid | GA | |
085726452A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Brendan C Engen |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1164558904 PECOS PAC ID: 2961566047 Enrollment ID: I20090204000533 |
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