BEHAVIORAL MEDICINE, LLC (NPI# 1457534513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457534513 |
| Entity Type | Organization |
| Organization Name | BEHAVIORAL MEDICINE, LLC |
| Practice Address |
3585 Vineville Ave Macon GA 31204-1872 |
| Practice Telephone | 4784760403 |
| Practice Fax Number | 4784769533 |
| Mailing Telephone | 4784760403 |
| Mailing Fax Number | 4784769533 |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |
| Authorized Official Name | DR. CHRISTOPHER J TILLITSKI (PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Telephone | 4784760403 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 001724 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE ID | 68BBDDL | 01 |
| Street Address |
3585 VINEVILLE AVE |
| City | MACON |
| State | GA |
| Zip Code | 31204-1872 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467545988 | Christopher Tillitski | Psychologist | 3585 Vineville Ave, Macon, GA 31204-1872 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775085 | Amy Lynn Miller | Counselor | 890 Northwoods Plaza/burrus Road, Macon, GA 31204 | 2018-10-04 |
| 1275056566 | Kenyada Moss | Counselor | 762 Thurmond Dr., Macon, GA 31204 | 2017-07-19 |
| 1508303876 | Amber Foster | Counselor | 890 Northwoods Plaza, Macon, GA 31204 | 2017-01-25 |
| 1952757585 | Sarah Vanselous Spencer | Speech-Language Pathologist | 2720 Sheraton Dr # D-140, Macon, GA 31204 | 2016-05-12 |
| 1952706343 | Matthew Wayne Frazier | Pharmacist | 4260 Log Cabin Dr, Macon, GA 31204 | 2014-10-28 |
| 1215338587 | Sharon Yvette Flewellen | Licensed Practical Nurse | 1876 Moore Street, Macon, GA 31204 | 2014-09-05 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1821439811 | Irene Gung Ho | Physician Assistant | 3203 Vineville Ave Ste A, Macon, GA 31204 | 2013-07-08 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1255599346 | Methodist Home of The South Georgia Conference, Inc. | Voluntary or Charitable | 304 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| Find all providers in zip 31204 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457599698 | Don Lessie Williams | Psychologist | 4041 Bowman Blvd Apt 408, Macon, GA 31210-0831 | 2009-01-27 |
| 1336287275 | Gena Helen Connally | Psychologist | 584 Arlington Pl, Macon, GA 31201-1705 | 2007-02-02 |
| 1720140700 | Mary Ann Drake | Psychologist | 1549 Coleman Ave, Macon, GA 31201-1517 | 2006-12-15 |
| 1639248982 | Daniel H Johnston | Psychologist | 144 Pierce Ave, Macon, GA 31204-2860 | 2006-11-08 |
| 1437266319 | Barbara Jane Calhoon | Psychologist | 168 Orange St, Macon, GA 31201-1660 | 2006-08-24 |
| 1629309778 | Joseph A Kot | Psychologist | 175 Emery Hwy, Macon, GA 31217-3692 | 2010-01-28 |
| 1427251586 | Barbara Calhoon, Ph.d. | Psychologist | 168 Orange St, Macon, GA 31201-1660 | 2007-06-07 |
| 1215140462 | Amy L Flowers, Ph.d. | Psychologist | 311 Pierce Ave, Macon, GA 31204-2421 | 2007-05-07 |
| 1649359142 | Amy Lee Flowers | Psychologist | 311 Pierce Ave, Macon, GA 31204-2421 | 2006-11-03 |
| 1215026067 | Leon Albert Hyer | Psychologist | 840 Pine St, Suite 880, Macon, GA 31201-2100 | 2006-10-12 |
| Find all providers in MACON | ||||
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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.