LOOKOUT MOUNTAIN COMMUNITY SERVICES (NPI# 1790782431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790782431 |
| Entity Type | Organization |
| Organization Name | LOOKOUT MOUNTAIN COMMUNITY SERVICES |
| Practice Address |
501 Mize St. Lafayette GA 30728 |
| Practice Telephone | 7066385580 |
| Practice Fax Number | 7066385445 |
| Mailing Telephone | 7066385580 |
| Mailing Fax Number | 7066385445 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | DR. THOMAS FORD (CEO) |
| Authorized Official Telephone | 7066385580 |
| Authorized Official Credential | PH D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | ========= | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00604513H | 05 | |
| GA | 00604513Z | 05 | |
| GA | 0604513U | 05 | |
| GA | 00604513C | 05 | |
| GA | 00604513D | 05 | |
| GA | 00810059A | 05 | |
| GA | 00604513B | 05 | |
| GA | 00604513E | 05 | |
| GA | 00604513G | 05 | |
| GA | 00810059G | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518418367 | Lookout Mountain Community Services | Community/Behavioral Health | 805 Moore Ave, La Fayette, GA 30728-3321 | 2016-10-17 |
| 1518415439 | Lookout Mountain Community Services | Community/Behavioral Health | 2009 Burma Rd, Rossville, GA 30741-3813 | 2016-09-20 |
| 1356899272 | Lookout Mountain Community Services | Community/Behavioral Health | 2508 Ringgold Rd, La Fayette, GA 30728-6324 | 2016-09-20 |
| 1912245150 | Lookout Mountain Community Services | Community/Behavioral Health | 377 Wildewood Trl, Chickamauga, GA 30707-3490 | 2013-01-23 |
| 1831321058 | Lookout Mountain Community Services | Community/Behavioral Health | 100 Savannah Ln, Summerville, GA 30747-7055 | 2009-08-21 |
| 1245478288 | Lookout Mountain Community Services | Community/Behavioral Health | 207 Millsap Rd, La Fayette, GA 30728-6339 | 2009-01-29 |
| 1942448444 | Lookout Mountain Community Services | Community/Behavioral Health | 568 Poplar St, Trenton, GA 30752-2511 | 2009-01-22 |
| 1396983896 | Lookout Mountain Community Services | Community/Behavioral Health | 600 Cannon Rd, La Fayette, GA 30728-6262 | 2009-01-22 |
| 1104064609 | Lookout Mountain Community Services | Community/Behavioral Health | 2448 Corinth Rd, La Fayette, GA 30728-3869 | 2009-01-22 |
| 1750529251 | Lookout Mountain Community Services | Community/Behavioral Health | 573 Southern Rd, Chickamauga, GA 30707-4215 | 2009-01-22 |
| Street Address |
501 MIZE ST. |
| City | LAFAYETTE |
| State | GA |
| Zip Code | 30728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669591384 | Alice Sue Dial | Licensed Practical Nurse | 501 Mize St., Lafayette, GA 30728 | 2007-03-28 |
| 1942326996 | Janet Audrey Mccollough | Counselor | 501 Mize St., Lafayette, GA 30728 | 2007-03-21 |
| 1588788269 | Sue Copelan | Counselor | 501 Mize St., Lafayette, GA 30728 | 2007-03-19 |
| 1659405967 | Gwendolyn W. Smith | Counselor | 501 Mize St., Lafayette, GA 30728 | 2007-03-16 |
| 1386716124 | Lookout Mountain Community Services | Community/Behavioral Health | 501 Mize St., Lafayette, GA 30728 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1891358750 | K -va -t Food Stores Inc | Durable Medical Equipment & Medical Supplies | 311 North Main Street, Lafayette, GA 30728 | 2019-04-17 |
| 1023505914 | Heather Staton | Pharmacist | 324 W. Patton Street, Lafayette, GA 30728 | 2018-04-17 |
| 1023484805 | Tyler Kellum Levie | Dentist | 201 E. Villanow Street, Lafayette, GA 30728 | 2015-08-17 |
| 1083987481 | Krishawna Elaine Montgomery | Counselor | 501 Mize Street Lookout Mountain Community Services, Lafayette, GA 30728 | 2012-02-15 |
| 1346518198 | William Randall Smith | Behavioral Analyst | 902 Daugherty Street, Lafayette, GA 30728 | 2011-12-08 |
| 1821321506 | John H Rockwell | Contractor | 143 Golden Oaks Dr, La Fayette, GA 30728 | 2009-09-11 |
| 1619113057 | Lookout Mountain Community Services | Community/Behavioral Health | 43 Shady Court, Lafayette, GA 30728 | 2009-01-06 |
| 1326212705 | Lookout Mountain Community Services | Community/Behavioral Health | 1218 Chattanooga St., Lafayette, GA 30728 | 2008-04-17 |
| 1649444084 | Lookout Mountain Community Services | Community/Behavioral Health | 29 Mae Tucker Rd., Lafayette, GA 30728 | 2008-04-16 |
| Find all providers in zip 30728 | ||||
| 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 |
|---|---|---|---|---|
| 1295333649 | Wanda Kaye's Heart | Community/Behavioral Health | 139b James Comeaux Rd # 563, Lafayette, LA 70508-3255 | 2020-10-16 |
| 1376151969 | Revived and Renewed Mental Health, LLC | Community/Behavioral Health | 4400 Ambassador Caffery Pkwy Ste A167, Lafayette, LA 70508-6760 | 2020-07-20 |
| 1316422470 | The Family Connection Inc. | Community/Behavioral Health | 116 Natchitoches Dr, Lafayette, LA 70506-7876 | 2018-09-25 |
| 1477032910 | Capitol Care, Inc. | Community/Behavioral Health | 22 Old Beaver Run Rd, Lafayette, NJ 07848-2004 | 2018-08-07 |
| 1265941595 | Benjamin White Psychotherapy, Pllc | Community/Behavioral Health | 601 S Longmont Ave, Lafayette, CO 80026-1539 | 2017-09-29 |
| 1871023994 | Nancy Bass Texada | Community/Behavioral Health | 525 South Buchanan, Lafayette, LA 70501 | 2017-06-13 |
| 1326571498 | Natasha Deville | Community/Behavioral Health | 1408 W Willow St 162, Lafayette, LA 70506 | 2017-04-06 |
| 1609237569 | K. Danielle Holmes, Lpc, LLC | Community/Behavioral Health | 143 Ridgeway Dr Ste 127, Lafayette, LA 70503-3414 | 2016-03-18 |
| 1588030571 | Chad Franks Counseling | Community/Behavioral Health | 143 Ridgeway Dr Ste 217, Lafayette, LA 70503-3410 | 2015-08-13 |
| 1497133508 | Mary F. Huval, Ncc, Lpc, LLC | Community/Behavioral Health | 850 Kaliste Saloom Rd Ste 204, Lafayette, LA 70508-4230 | 2015-05-08 |
| Find all providers in LAFAYETTE | ||||
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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.