BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA (NPI# 1396810412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396810412 |
| Entity Type | Organization |
| Organization Name | BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA |
| Other Organization Name | LOWNDES C&A OUTPATIENT CLINIC |
| Practice Address |
3120 N Oak Street Ext Ste B Valdosta GA 31602-5910 |
| Mailing Address |
3120 N Oak Street Ext Ste C Valdosta GA 31602-5910 |
| Practice Telephone | 2296716164 |
| Practice Fax Number | 2296716750 |
| Mailing Telephone | 2296716100 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-03-31 |
| Authorized Official Name | MR. WILLIAM F. HULING (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2296716140 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000742475M | 05 |
| Other Name | Type Code |
|---|---|
| Legacy Behavioral Health Services | Doing Business As Name - Organization |
| Lowndes C&A Outpatient Clinic | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3120 N Oak Street Ext Ste E, Valdosta, GA 316025910 | 2296716150 |
| 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 |
| 1255875910 | Behavioral Health Services of South Georgia | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2016-12-14 |
| 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 |
| 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 |
3120 N OAK STREET EXT STE B |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-5910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982786224 | Paresh Thanki | Psychiatry & Neurology | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2006-10-19 |
| 1164038535 | Emily Crawford | Marriage & Family Therapist | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2020-09-21 |
| 1871103192 | Lori Allison Keith | Social Worker | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2020-08-01 |
| 1962020958 | Kaitlyn Floyd | Marriage & Family Therapist | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2020-07-07 |
| 1629600432 | Jenny Marie Reid | Nurse Practitioner | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2020-02-10 |
| 1902367824 | Maria Guadalupe Castaneda | Social Worker | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2019-03-26 |
| 1578020616 | Jorden Linsey Milne | Social Worker | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2019-02-25 |
| 1174099535 | Holly Elizabeth Jones | Counselor | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2018-10-23 |
| 1194291625 | Andrew J Courson | Counselor | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2018-10-23 |
| 1205333424 | Shelby Lane Elder | Nurse Practitioner | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2018-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306451265 | Chrystal Care | Clinic/Center | 3206 Stratford Cir, Morrow, GA 30260-8111 | 2020-09-08 |
| 1114536372 | The Mindful Match, LLC | Clinic/Center | 528b Angier Ave Ne, Atlanta, GA 30308-2902 | 2020-07-23 |
| 1427666817 | Atlanta Child and Family Therapy, LLC | Clinic/Center | 2144 Kodiak Dr Ne, Atlanta, GA 30345-4150 | 2020-07-21 |
| 1407474778 | Your Way Out, LLC | Clinic/Center | 2330 Scenic Hwy S Ste 316, Snellville, GA 30078-3115 | 2020-07-13 |
| 1073141271 | Monte Nido Georgia LLC | Clinic/Center | 126 Johnson Ferry Road Ne, Sandy Springs, GA 30328-3004 | 2020-04-01 |
| 1700418142 | Behavior Therapy Solutions LLC | Clinic/Center | 4744 N Royal Atlanta Dr Ste A, Tucker, GA 30084-3820 | 2020-02-04 |
| 1730721036 | Brown Professional Counseling & Consultation Services, LLC | Clinic/Center | 1105 Russell Pkwy Ste 2, Warner Robins, GA 31088-5586 | 2019-10-09 |
| 1184182115 | Pathways To Recovery Associates Inc. | Clinic/Center | 7210 Church St, Riverdale, GA 30274-2918 | 2019-03-08 |
| 1336614254 | Learn & Grow Family Counseling, LLC | Clinic/Center | 327 Dahlonega St Ste 402, Cumming, GA 30040-2486 | 2018-10-07 |
| 1790271633 | Jill Elizabeth Gresham | Clinic/Center | 750 Hammond Dr Ste 100, Atlanta, GA 30328-5532 | 2018-07-03 |
| Find all providers with the same taxonomy | ||||
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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.