| The Renaissance Centre, Inc. | |
|
506 N Jackson St Albany GA 31701 | |
| (229) 889-7200 | |
| (229) 889-7393 |
| Full Name | The Renaissance Centre, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 506 N Jackson St, Albany, Georgia |
| Authorized Official Name and Position | Margaret Beck (OFFICE MANAGER) |
| Authorized Official Contact | 2298897200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Renaissance Centre, Inc. 506 N Jackson St. Albany GA 31701 Ph: (229) 889-7200 | The Renaissance Centre, Inc. 506 N Jackson St Albany GA 31701 Ph: (229) 889-7200 |
| NPI Number | 1104970193 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 07/12/2011 |
| Medicare PECOS PAC ID | 4587656962 |
|---|---|
| Medicare Enrollment ID | O20040402001248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104970193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Sasi K Nayudu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942284468 PECOS PAC ID: 3870531767 Enrollment ID: I20050421000137 |
| Provider Name | Malinda Dale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629050570 PECOS PAC ID: 0345416483 Enrollment ID: I20111220000694 |
| Provider Name | Ann S Priddy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982688198 PECOS PAC ID: 8426224569 Enrollment ID: I20111220000704 |
| Provider Name | Nick A Carden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710969654 PECOS PAC ID: 6406022540 Enrollment ID: I20111220000733 |
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