| Compassionate Behavioral Health | |
|
408 Shirley Ave Douglas GA 31533-2002 | |
| (912) 292-1177 | |
| (912) 292-0241 |
| Full Name | Compassionate Behavioral Health |
|---|---|
| Speciality | Social Worker |
| Location | 408 Shirley Ave, Douglas, Georgia |
| Authorized Official Name and Position | Sara E Atkinson (OWNER) |
| Authorized Official Contact | 9123812504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassionate Behavioral Health 408 Shirley Ave Douglas GA 31533-2002 Ph: (912) 292-1177 | Compassionate Behavioral Health 408 Shirley Ave Douglas GA 31533-2002 Ph: (912) 292-1177 |
| NPI Number | 1629506787 |
|---|---|
| Provider Enumeration Date | 06/01/2017 |
| Last Update Date | 09/11/2023 |
| Certification Date | 09/11/2023 |
| Medicare PECOS PAC ID | 3779825716 |
|---|---|
| Medicare Enrollment ID | O20190423002517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629506787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW005528 (Georgia) | Primary |
| Provider Name | William F Shivers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457420614 PECOS PAC ID: 9931196920 Enrollment ID: I20040430000091 |
| Provider Name | Edyn B Mckinnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235595604 PECOS PAC ID: 2163711961 Enrollment ID: I20160518001067 |
| Provider Name | Jesse Mckinnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407219314 PECOS PAC ID: 5698069953 Enrollment ID: I20160809001733 |
| Provider Name | Sara E Atkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891122339 PECOS PAC ID: 1658652136 Enrollment ID: I20161220002265 |
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