SOUTH GEORGIA PSYCHOLOGICAL SERVICES PC


Address: 104 Dunkirk Ln, Brunswick, GA 31523-6379
Phone: 9125549989

SOUTH GEORGIA PSYCHOLOGICAL SERVICES PC (NPI# 1083914881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083914881
Entity Type Organization
Organization Name SOUTH GEORGIA PSYCHOLOGICAL SERVICES PC
Practice Address 104 Dunkirk Ln
Brunswick
GA 31523-6379
Practice Telephone 9125549989
Practice Fax Number 9125543399
Mailing Telephone 9125549989
Mailing Fax Number 9125543399
Enumeration Date 2010-10-26
Last Update Date 2010-10-26
Authorized Official Name DR. NANCY L OGLETREE (PSYCHOLOGIST)
Authorized Official Telephone 9125549989
Authorized Official Credential PH.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
PSY001903 GA Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
GA 000528514A 05

Office Location

Street Address 104 DUNKIRK LN
City BRUNSWICK
State GA
Zip Code 31523-6379

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1851494512 Georgia Cvs Pharmacy LLC Pharmacy 5421 New Jesup Hwy, Brunswick, GA 31523-1137 2006-09-07
1669812574 Paladin Sleep Services LLC Clinic/Center 167 Highland Park Cir, Brunswick, GA 31523-1161 2013-06-25
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952942559 Andrea J Medaris Psychologist 153 Park Row Ste 302, Brunswick, ME 04011-2053 2019-10-04
1548770332 Amanda Seirup Psychologist 16 Lincoln St Ste C, Brunswick, ME 04011-1900 2017-10-05
1346601218 Susanna Preziosi Psychologist 14 Maine St Ste 309, Brunswick, ME 04011-2033 2016-03-18
1124296231 Discovering Choices, Inc. Psychologist 51 Harpswell Rd, Suite 103, Brunswick, ME 04011-2549 2008-02-12
1629125273 George Steffian Psychologist Fasotragrulant, Detachment Brunswick, 1801 Burbank Ave, Brunswick, ME 04011 2007-01-05
1760577092 William R Johnson Psychologist 1421 Lee Street, Brunswick, GA 31520 2006-10-03
1316972797 David C Bellows Psychologist 240 Maine St, Brunswick, ME 04011-3365 2006-07-12
1053391367 Anita Laurette Goller Psychologist 6 Cumberland St, Brunswick, ME 04011-1904 2006-01-20
1790219921 Michelle Kanga Psychologist 14 Maine St, Suite 309, Brunswick, ME 04011-2049 2017-04-14
1700320397 Erin Sheets Psychologist 14 Maine St Ste 309, Brunswick, ME 04011-2052 2016-12-15
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Competitor

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City BRUNSWICK
Zip Code 31523

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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