| Connie Stapleton Phd | |
|
2915 Professional Pkwy Suite C Augusta GA 30907-6521 | |
| (706) 364-5228 | |
| (706) 364-5229 |
| Full Name | Connie Stapleton Phd |
|---|---|
| Speciality | Psychologist |
| Location | 2915 Professional Pkwy, Augusta, Georgia |
| Authorized Official Name and Position | Connie Stapleton (PSYCHOLOGIST) |
| Authorized Official Contact | 7063645228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Connie Stapleton Phd 2915 Professional Pkwy Suite C Augusta GA 30907-6521 Ph: (706) 364-5228 | Connie Stapleton Phd 2915 Professional Pkwy Suite C Augusta GA 30907-6521 Ph: (706) 364-5228 |
| NPI Number | 1164464814 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6709891658 |
|---|---|
| Medicare Enrollment ID | O20060214000074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164464814 | NPI | - | NPPES |
| 497373 | Other | GA | VALUE OPTIONS |
| 52821111-001 | Other | GA | BCBS ID# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2412 (Georgia) | Primary |
| Provider Name | Constance D Stapleton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720080872 PECOS PAC ID: 1456375229 Enrollment ID: I20060220000015 |
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