| Bright Impact Behavioral Practice | |
|
1012 Ga Highway 247 S Kathleen GA 31047-2349 | |
| (943) 200-0016 | |
| Not Available |
| Full Name | Bright Impact Behavioral Practice |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1012 Ga Highway 247 S, Kathleen, Georgia |
| Authorized Official Name and Position | Stacyann Samuels (REGIONAL DIRECTOR) |
| Authorized Official Contact | 9432000016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Impact Behavioral Practice 1012 Ga Highway 247 S Kathleen GA 31047-2349 | Bright Impact Behavioral Practice 1012 Ga Highway 247 S Kathleen GA 31047-2349 Ph: (943) 200-0016 |
| NPI Number | 1932075942 |
|---|---|
| Provider Enumeration Date | 10/15/2025 |
| Last Update Date | 10/15/2025 |
| Certification Date | 10/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932075942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (NU) | Primary |
| 106E00000X | Assistant Behavior Analyst | (NU) | Secondary |
| 106S00000X | Behavior Technician | (NU) | Secondary |
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