| Paulette Chavers, MED, LPC | |
| 
					305 W Spring St, Mount Vernon, GA 30445-2837  | |
| (912) 423-0498 | |
| Not Available | 
| Full Name | Paulette Chavers | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Professional | 
| Location | 305 W Spring St, Mount Vernon, Georgia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1336551415 | NPI | - | NPPES | 
| 003155049B | Medicaid | GA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC007713 (Georgia) | Primary | 
| Entity Name | Privia Medical Group Of Georgia Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1013313857 PECOS PAC ID: 4284951542 Enrollment ID: O20150325000983  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Paulette Chavers, MED, LPC 305 W Spring St, Mount Vernon, GA 30445-2837 Ph: () -  | Paulette Chavers, MED, LPC 305 W Spring St, Mount Vernon, GA 30445-2837 Ph: (912) 423-0498  | 
Mr. Thadeus Mandrall Holloway, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 305 W Spring St, Box 172, Mount Vernon, GA 30445 Phone: 912-423-1000 Fax: 912-583-0115  | |
Crystal Coney, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 421 W Robinson Dr, Mount Vernon, GA 30445 Phone: 912-583-0100 Fax: 912-583-0115  | |
Tyhescia White, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 305 W Spring St, Post Office Box 172, Mount Vernon, GA 30445 Phone: 912-423-0498 Fax: 912-583-0115  | |
Shonda Lafaye Madison, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 N Minnie St, Mount Vernon, GA 30445 Phone: 912-583-2172  | |
Amber Mcarthur, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 305 W Spring St, Mount Vernon, GA 30445 Phone: 912-423-0498 Fax: 912-583-0115  |