| Center Point Ga, Inc. | |
|
1050 Elephant Trl Gainesville GA 30501-3016 | |
| (770) 535-1050 | |
| (770) 534-8204 |
| Full Name | Center Point Ga, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1050 Elephant Trl, Gainesville, Georgia |
| Authorized Official Name and Position | David Lynn Smith (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7705351050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center Point Ga, Inc. 1050 Elephant Trl Gainesville GA 30501-3016 Ph: (770) 535-1050 | Center Point Ga, Inc. 1050 Elephant Trl Gainesville GA 30501-3016 Ph: (770) 535-1050 |
| NPI Number | 1154443240 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 12/17/2015 |
| Medicare PECOS PAC ID | 5294044145 |
|---|---|
| Medicare Enrollment ID | O20151016000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154443240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | CSW003717 (Georgia) | Primary |
| Provider Name | John Marshall Bruner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225331606 PECOS PAC ID: 6002078094 Enrollment ID: I20120509000363 |
| Provider Name | Tamyra Crossley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235729633 PECOS PAC ID: 2769891282 Enrollment ID: I20210512002026 |
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