| Ellijay Center for Change, PC | |
|
89 Hospital Cir Suite 8 Ellijay GA 30540-9669 | |
| (706) 698-2400 | |
| (706) 698-2401 |
| Full Name | Ellijay Center for Change, PC |
|---|---|
| Speciality | Counselor |
| Location | 89 Hospital Cir, Ellijay, Georgia |
| Authorized Official Name and Position | Cheryl Keats (OWNER) |
| Authorized Official Contact | 7066982400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellijay Center for Change, PC 89 Hospital Cir Suite 8 Ellijay GA 30540-9669 Ph: (706) 698-2400 | Ellijay Center for Change, PC 89 Hospital Cir Suite 8 Ellijay GA 30540-9669 Ph: (706) 698-2400 |
| NPI Number | 1669700837 |
|---|---|
| Provider Enumeration Date | 11/30/2009 |
| Last Update Date | 11/30/2009 |
| Medicare PECOS PAC ID | 7416120175 |
|---|---|
| Medicare Enrollment ID | O20130710000866 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669700837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CSW001990 (Georgia) | Primary |
| Provider Name | Cheryl M Keats |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841254307 PECOS PAC ID: 0345219531 Enrollment ID: I20130710000912 |
Highland Rivers Fannin/gilmer County Office Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18090 Highway 515 N, Ellijay, GA 30536 Phone: 706-276-2024 Fax: 706-276-1502 |
Highland Rivers Gilmer C&a Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18090 Highway 515 N, Ellijay, GA 30536 Phone: 706-276-2024 Fax: 706-276-1502 |
Willow Creek Adolescent Substance Abuse Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Kiker St, Ellijay, GA 30540 Phone: 706-636-2692 Fax: 706-636-2694 |
Lighthouse Treatment Centers of Georgia LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 37 Kiker St, Ellijay, GA 30540 Phone: 706-636-5483 Fax: 706-636-5495 |
Beginnings Psychology Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 89 Hospital Cir, Suite 7, Ellijay, GA 30540 Phone: 706-635-8878 Fax: 706-635-8878 |
Highland Rivers Community Service Board Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 Parksbrook Rd, Ellijay, GA 30540 Phone: 706-270-5033 Fax: 706-370-7749 |