DR. MARY DECRUISE (NPI# 1679758429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679758429 |
| Entity Type | Individual |
| Full Name | DR. MARY DECRUISE |
| Credential | PSY.D |
| Practice Address |
2450 Vinson Hwy Milledgeville GA 31062 |
| Mailing Address |
7040 Peake Rd N Unit 26012 Macon GA 31221-1001 |
| Practice Telephone | 4782843985 |
| Mailing Telephone | 4782843985 |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2020-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
20-06 | AR | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
021513 | NY | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
7636 | FL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
0810004038 | VA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
4268 | NC | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3737 | GA | Behavioral Health & Social Service Providers |
| Street Address |
2450 VINSON HWY |
| City | MILLEDGEVILLE |
| State | GA |
| Zip Code | 31062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922668169 | Lufti I Yargic | Psychiatry & Neurology | Csh - Cook Building 2450 Vinson Highway, Milledgeville, GA 31062-0001 | 2019-06-19 |
| 1770047276 | Ekrem Dogan | Internal Medicine | 2450 Vinson Highway Cook Building, Milledgeville, GA 31062-0001 | 2019-01-29 |
| 1144703497 | Tara Walker | Nurse Practitioner | Central State Hospital 2450 Vinson Hwy, Milledgeville, GA 31062-0001 | 2018-09-12 |
| 1356586259 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1631 Valley Cir, Milledgeville, GA 31062-0001 | 2008-12-05 |
| 1841487667 | Georgia Department of Human Resources | General Acute Care Hospital | 2400 Vinson Hwy, Milledgeville, GA 31062-0001 | 2007-09-25 |
| 1659369866 | Clinton Wade Hodges | Pharmacist | Csh Pharmaceutical Services, Lawrence Rd., Milledgeville, GA 31062-0001 | 2005-10-11 |
| 1922621184 | Uzma Beg | Psychiatry & Neurology | 2450 Vinson Highway Cook Building, Milledgeville, GA 31062-0001 | 2020-05-22 |
| 1114010485 | Jeffrey D'neil Harris | Psychologist | 2450 Vinson Highway, Milledgeville, GA 31062-1622 | 2006-10-01 |
| 1235527144 | Loukisha Monique Roberts | Registered Nurse | 2450 Vinson Highway, Milledgeville, GA 31062-5641 | 2014-12-30 |
| 1558872515 | Rachel Evans | Specialist/Technologist | 231 W Hancock St, Milledgeville, GA 31062-6156 | 2017-10-18 |
| Find all providers in zip 31062 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649336884 | John Wylie Gamble | Psychologist | 118 S Wilkinson St, Suite 8, Milledgeville, GA 31061-3356 | 2006-12-30 |
| 1881754034 | Michael P. Rose | Psychologist | 136 W Mcintosh St Ste D, Milledgeville, GA 31061-3463 | 2006-12-11 |
| 1376611921 | Theresa Betts | Psychologist | 1007 Riverbend Rd Se, Milledgeville, GA 31061-4837 | 2006-12-01 |
| 1114010485 | Jeffrey D'neil Harris | Psychologist | 2450 Vinson Highway, Milledgeville, GA 31062-1622 | 2006-10-01 |
| 1720302748 | Patricia Jean Marterer | Psychologist | 2450 Vinson Hwy Se, Milledgeville, GA 31061-4881 | 2010-03-19 |
| 1447261581 | Kamal E. Campbell | Psychologist | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403462 | Molly Elizabeth Katherine Mclaren | Psychologist | 1441 Clifton Rd Ne Ste 170, Atlanta, GA 30322-1004 | 2020-10-07 |
| 1588261945 | Raven Evans | Psychologist | 1800 Lake Park Dr Se Ste 123, Smyrna, GA 30080-7639 | 2020-10-07 |
| 1255945572 | Kerri Eileen Woodward | Psychologist | 6000 Lake Forrest Dr Ste 103, Atlanta, GA 30328-5902 | 2020-09-03 |
| 1932721784 | Essential Counseling & Consulting, Inc | Psychologist | 2800 Old Spanish Trl, College Park, GA 30349-4266 | 2020-05-15 |
| 1689296980 | Natalie N Watson-singleton | Psychologist | 2124 Cheshire Bridge Rd Ne Apt 4112, Atlanta, GA 30324-5733 | 2020-05-11 |
| 1336760164 | Lauren Olivia Patterson | Psychologist | 209 Thornwood Ct, Statesboro, GA 30458-0296 | 2020-05-04 |
| 1972123883 | Elizabeth Newton, Psyd and Assoc Inc | Psychologist | 1827 Powers Ferry Rd, Bldg 21, Atlanta, GA 30339 | 2020-04-21 |
| 1669091989 | Juliet Anne Buchwalter | Psychologist | 49 Lenox Pointe Ne Ste A, Atlanta, GA 30324-7426 | 2020-04-16 |
| 1790319549 | Thaddeus Reecesiri Reece | Psychologist | 771 Tulip Poplar Way, Lawrenceville, GA 30044-8819 | 2020-03-02 |
| 1508498395 | Walker Consulting & Psychological Services | Psychologist | 4375 Cobb Pkwy Se Ste 121, Atlanta, GA 30339-5537 | 2020-02-10 |
| Find all providers with the same taxonomy | ||||
| City | MILLEDGEVILLE |
| Zip Code | 31062 |
Please comment or provide details below to improve the information on DR. MARY DECRUISE.
| 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.