GEORGIA PSYCHOLOGICAL SERVICES (NPI# 1811044464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811044464 |
| Entity Type | Organization |
| Organization Name | GEORGIA PSYCHOLOGICAL SERVICES |
| Practice Address |
4139 Columbia Rd Ste A Martinez GA 30907-5401 |
| Mailing Address |
Po Box 211626 Augusta GA 30917-1626 |
| Practice Telephone | 7062103066 |
| Practice Fax Number | 7062108703 |
| Mailing Telephone | 7062103066 |
| Mailing Fax Number | 7062108703 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DAVID WAYNE PROEFROCK (CEO) |
| Authorized Official Telephone | 7062103066 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 8840000796A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548571243 | Georgia Psychological Services | Clinic/Center | 3787 Uppark Dr, Atlanta, GA 30349-8731 | 2010-06-28 |
| Street Address |
4139 COLUMBIA RD STE A |
| City | MARTINEZ |
| State | GA |
| Zip Code | 30907-5401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275158156 | Mary Cameron Elizabeth Robert | Dentist | 3226 Washington Rd, Augusta, GA 30907 | 2020-06-16 |
| 1841760451 | Debra E Gibbs | Dental Hygienist | 523 Crystal Creek West, Martinez, GA 30907 | 2018-11-27 |
| 1083183651 | Leslie Yvonne Watkins | Massage Therapist | 3450 River Watch Parkway, Suite 100, Martinez, GA 30907 | 2018-11-13 |
| 1124594718 | Kimberly A Delaigle | Nurse Practitioner | 3475 Riverwatch Parkway, Suite 310, Martinez, GA 30907 | 2018-10-22 |
| 1366960825 | Catherine Lane Hopkins | Speech-Language Pathologist | 435 Cambridge Circle, Martinez, GA 30907 | 2017-09-05 |
| 1518485143 | Challenging Perspectives | Clinic/Center | 3710 Executive Center Dr Suite B, Martinez, GA 30907 | 2017-09-04 |
| 1386168490 | Carlene Elizabeth Lemcke | Speech-Language Pathologist | 3580 Riverwatch Parkway, Martinez, GA 30907 | 2017-07-31 |
| 1619499357 | Orchid Archer | Registered Nurse | 702 Riverbend Drive, Martinez, GA 30907 | 2017-07-14 |
| 1437679339 | Mediator Senior Care, LLC | In Home Supportive Care | 4143 Columbia Rd., Suite B, Martinez, GA 30907 | 2017-06-21 |
| 1518407907 | Augusta Smilecare PC | Dentist | 4200 Columbia Road, Martinez, GA 30907 | 2017-03-03 |
| Find all providers in zip 30907 | ||||
| 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 |
|---|---|---|---|---|
| 1598018897 | Contra Costa Arc - Lynn Center | Community/Behavioral Health | 1340 Arnold Dr Ste 121, Martinez, CA 94553-4189 | 2012-10-24 |
| 1689715880 | Youth Development Corporation of America | Community/Behavioral Health | 4424 Columbia Rd, Ste B, Martinez, GA 30907-4565 | 2007-02-09 |
| 1245854207 | Agape Behavioral Healthcare and Counseling, LLC . | Community/Behavioral Health | 3711 Executive Center Dr, Martinez, GA 30907-0951 | 2020-06-04 |
| 1124596333 | Contra Costa County | Community/Behavioral Health | 1350 Arnold Dr Ste 102, Martinez, CA 94553-4190 | 2018-11-06 |
| 1760982169 | Contra Costa County | Community/Behavioral Health | 1340 Arnold Dr Ste 200, Martinez, CA 94553-4189 | 2018-02-13 |
| 1447762521 | Seneca Family of Agencies | Community/Behavioral Health | 150 E St, Martinez, CA 94553-3139 | 2017-10-30 |
| 1841635554 | Rising Tide Behavioral Interventions, LLC | Community/Behavioral Health | 305 Habersham Rd, Martinez, GA 30907-9073 | 2013-05-08 |
| 1588965651 | Contra Costa County Health Services | Community/Behavioral Health | 10 Douglas Dr Ste 140, Martinez, CA 94553-4078 | 2010-11-05 |
| 1629257928 | Martinez Detention Facility | Community/Behavioral Health | 1000 Ward St, Martinez, CA 94553-1360 | 2007-11-02 |
| 1851586572 | Seneca Center | Community/Behavioral Health | 1320 Arnold Dr, Suite 160, Martinez, CA 94553-6537 | 2007-09-06 |
| Find all providers in MARTINEZ | ||||
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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.