| A Beautiful Mind Psychiatry | |
|
1732 N Broad St Commerce GA 30529-1903 | |
| (706) 449-2884 | |
| Not Available |
| Full Name | A Beautiful Mind Psychiatry |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1732 N Broad St, Commerce, Georgia |
| Authorized Official Name and Position | Charmaine Wilson (OWNER) |
| Authorized Official Contact | 7064492884 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Beautiful Mind Psychiatry 4395 Fulton Industrial Blvd Sw Ste D Atlanta GA 30336-1955 Ph: (706) 449-2884 | A Beautiful Mind Psychiatry 1732 N Broad St Commerce GA 30529-1903 Ph: (706) 449-2884 |
| NPI Number | 1861266397 |
|---|---|
| Provider Enumeration Date | 11/15/2023 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Medicare PECOS PAC ID | 0840736435 |
|---|---|
| Medicare Enrollment ID | O20240718004351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861266397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kecia Marshall Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578153235 PECOS PAC ID: 5092178228 Enrollment ID: I20230905003699 |
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