Southeastern Behavioral Health And Consulting
Psychologist, Clinical in Newnan, GA. Organization (NPI-2).
NPI number1659924751
StatusActive
Last updated in NPPESJul 18, 2019
Details
- NPI
- 1659924751
- Entity type
- Organization (NPI-2)
- Legal business name
- Southeastern Behavioral Health And Consulting
- Organization subpart
- No
- Enumeration date
- Jul 18, 2019
- Last updated
- Jul 18, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
| 103T00000X | Psychologist | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
53 Poplar StNewnan, GA 30263-1039
Phone 404-516-1996
Mailing address
2997 Cobb Pkwy Se Unit 725575Atlanta, GA 31139-2703
Phone 404-516-1996
Authorized official
Michelle Mitchell
Chief Managing Officer
4045161996
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