BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA (NPI# 1255875910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255875910 |
| Entity Type | Organization |
| Organization Name | BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA |
| Practice Address |
334 Tifton Eldorado Rd Tifton GA 31794-9497 |
| Mailing Address |
3120 N Oak Street Ext Suite C Valdosta GA 31602-5909 |
| Practice Telephone | 2293912301 |
| Mailing Telephone | 2296716700 |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |
| Authorized Official Name | ROZ JOHNSON (CHIEF CLINICAL OFFICER) |
| Authorized Official Telephone | 2296716700 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MFT001515 | GA | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831671973 | Behavioral Health Services of South Georgia | Clinic/Center | 201 W Mcpherson Ave, Nashville, GA 31639-2131 | 2018-09-05 |
| 1528132321 | Behavioral Health Services of South Georgia | Community Based Residential Treatment Facility, Mental Illness | 1 Dellwood Cir, Valdosta, GA 31602-2335 | 2006-11-20 |
| 1083787287 | Behavioral Health Services of South Georgia | Clinic/Center | 507 Laurel St, Nashville, GA 31639-2555 | 2006-11-16 |
| 1912986282 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Suite C, Valdosta, GA 31602-1007 | 2006-01-13 |
| 1083754535 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 | 2007-02-07 |
| 1639219181 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 | 2007-02-07 |
| 1881734333 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Valdosta, GA 31602-1007 | 2007-02-07 |
| 1801932371 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Suite C, Valdosta, GA 31602-1007 | 2007-01-30 |
| 1588739601 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2006-11-22 |
| 1396810412 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2006-11-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 |
| Street Address |
334 TIFTON ELDORADO RD |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-9497 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558457655 | South Georgia Csb | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2006-10-05 |
| 1043844418 | Amanda L Cofield | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2020-02-25 |
| 1124674767 | Robin Meadows | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2019-08-09 |
| 1487219770 | Nyesia Knight | Counselor | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2019-05-02 |
| 1275090086 | Daniel Jason Spratlin | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2019-02-28 |
| 1487146932 | Norma Ann Chin | Counselor | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2018-05-31 |
| 1235621897 | Jodi Evans Lott | Nurse Practitioner | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2018-05-30 |
| 1760929228 | Tyundreya Lindsey | Marriage & Family Therapist | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2017-01-23 |
| 1265976435 | Davina G Samuel | Counselor | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2016-12-07 |
| 1437523859 | Aneisa Marie Young | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2015-11-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558457655 | South Georgia Csb | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2006-10-05 |
| 1407463177 | Give Kindness Wing | Community/Behavioral Health | 911 Main St S, Tifton, GA 31794-4867 | 2020-09-28 |
| 1609216027 | Georgia Pines Community Service Board | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2013-06-29 |
| 1720156508 | Southwestern State Hospital | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376160 | Love, Breanna Olivia Zion Enterprise,llc(lboz): | Community/Behavioral Health | 9802 N Ivy Park Dr, Fortson, GA 31808-7130 | 2020-11-02 |
| 1578170882 | Helping Hearts Behavioral Health Services, LLC | Community/Behavioral Health | 504 Hamlet Dr, Hampton, GA 30228-4829 | 2020-09-30 |
| 1982219523 | Future Seekers, Inc. | Community/Behavioral Health | 3475 N. Desert Drive, Building 1, Suite 2100, East Point, GA 30344-3034 | 2020-09-10 |
| 1396359840 | Just Like Family Caregivers | Community/Behavioral Health | 2628 Lovejoy Crossing St, Hampton, GA 30228-5995 | 2020-09-02 |
| 1285247270 | Hudu Yoga & Therapy | Community/Behavioral Health | 3900 Springleaf Ct, Stone Mountain, GA 30083-4692 | 2020-08-28 |
| 1952914632 | Brighter Dayz, Incorporated | Community/Behavioral Health | 1016 Howell Mill Rd Nw Apt 4408, Atlanta, GA 30318-5592 | 2020-08-24 |
| 1699387688 | Rise Rehabilitation Services, LLC | Community/Behavioral Health | 738 Highland Park Trl, Atlanta, GA 30350-6706 | 2020-08-20 |
| 1104438373 | Pivotal Counseling LLC | Community/Behavioral Health | 75 N Broad St, Winder, GA 30680-1907 | 2020-08-19 |
| 1295347888 | Freemans Early Intervention Services | Community/Behavioral Health | 13 Peach St, Butler, GA 31006 | 2020-08-17 |
| 1861017634 | Trinity Care Counseling | Community/Behavioral Health | 3475 Northwinds Parkway, 200, Alpharetta, GA 30009 | 2020-06-08 |
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| 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.