| Gateway Community Service Board | |
|
700 Coastal Village Drive Brunswick GA 31520 | |
| (912) 554-8510 | |
| (912) 264-5965 |
| Full Name | Gateway Community Service Board |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 700 Coastal Village Drive, Brunswick, Georgia |
| Authorized Official Name and Position | Miranda May (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 9122807023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Community Service Board 121 Burgess Rd Brunswick GA 31523-9311 Ph: (912) 280-7023 | Gateway Community Service Board 700 Coastal Village Drive Brunswick GA 31520 Ph: (912) 554-8510 |
| NPI Number | 1558478214 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 03/31/2026 |
| Certification Date | 03/31/2026 |
| Medicare PECOS PAC ID | 3173510237 |
|---|---|
| Medicare Enrollment ID | O20040429000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558478214 | NPI | - | NPPES |
| 300030904A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
| Provider Name | Ganiat M Ajayi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023170842 PECOS PAC ID: 1052386893 Enrollment ID: I20040826000676 |
| Provider Name | Chrissie Clure |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255413654 PECOS PAC ID: 1254397003 Enrollment ID: I20041203000629 |
| Provider Name | Leon a Hyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215026067 PECOS PAC ID: 4688616493 Enrollment ID: I20061218000390 |
| Provider Name | Edward M Drohan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518929223 PECOS PAC ID: 5092816447 Enrollment ID: I20070730000092 |
| Provider Name | Kayln T Lane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619154028 PECOS PAC ID: 1153489851 Enrollment ID: I20081024000350 |
| Provider Name | Kevin J Winders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275577520 PECOS PAC ID: 3173539954 Enrollment ID: I20100604000004 |
| Provider Name | Stacy Mullins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255613485 PECOS PAC ID: 3476713629 Enrollment ID: I20120326000194 |
| Provider Name | Krystle Leigh Graham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225268949 PECOS PAC ID: 4880844067 Enrollment ID: I20121024000484 |
| Provider Name | Kemaya L Wilburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841675667 PECOS PAC ID: 3779893052 Enrollment ID: I20151117002461 |
| Provider Name | Jesse Mckinnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407219314 PECOS PAC ID: 5698069953 Enrollment ID: I20160809001733 |
| Provider Name | Iris Heather Burandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740733732 PECOS PAC ID: 6800179540 Enrollment ID: I20170203001173 |
| Provider Name | Alicia Conn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538604368 PECOS PAC ID: 0648555730 Enrollment ID: I20170403001718 |
| Provider Name | Ruby W Pontello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538162185 PECOS PAC ID: 7618061672 Enrollment ID: I20170908002956 |
| Provider Name | Karen E Brazell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689035032 PECOS PAC ID: 4789958364 Enrollment ID: I20170920002110 |
| Provider Name | Carlie L Tilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871953729 PECOS PAC ID: 4183988892 Enrollment ID: I20180504001486 |
| Provider Name | Jessica Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992218986 PECOS PAC ID: 0143584748 Enrollment ID: I20180508000687 |
| Provider Name | Camden Calvin Helder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366933046 PECOS PAC ID: 8921356908 Enrollment ID: I20180808000168 |
| Provider Name | Sonya Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427561752 PECOS PAC ID: 6608125125 Enrollment ID: I20180816002268 |
| Provider Name | Grace Peralta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841760345 PECOS PAC ID: 7214260769 Enrollment ID: I20190614002165 |
| Provider Name | Yoshi T Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023670148 PECOS PAC ID: 5991137796 Enrollment ID: I20191116000323 |
| Provider Name | Angela K Llewellyn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154801454 PECOS PAC ID: 6608120001 Enrollment ID: I20200124000834 |
| Provider Name | Jay Synn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518026160 PECOS PAC ID: 2668417759 Enrollment ID: I20201112000358 |
| Provider Name | Paige Lindsay Marnell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619316163 PECOS PAC ID: 3971806621 Enrollment ID: I20210413000273 |
| Provider Name | Lisa Gauthier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972107944 PECOS PAC ID: 7618376914 Enrollment ID: I20210518002047 |
| Provider Name | Domonic Jovan Hill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962821033 PECOS PAC ID: 1254636327 Enrollment ID: I20210916001418 |
| Provider Name | Emily Aquadro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417418344 PECOS PAC ID: 6204169568 Enrollment ID: I20211227000285 |
| Provider Name | Shirley R Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699437970 PECOS PAC ID: 1850785742 Enrollment ID: I20220217002404 |
| Provider Name | Nicole a Stallworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801292941 PECOS PAC ID: 3870967565 Enrollment ID: I20230320002999 |
| Provider Name | Yvonne Efeoghene Erusiafe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780145607 PECOS PAC ID: 6204178189 Enrollment ID: I20230407001250 |
| Provider Name | Nisha Ramchander |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104455674 PECOS PAC ID: 1658701347 Enrollment ID: I20230428002506 |
| Provider Name | Mary Mercer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538796925 PECOS PAC ID: 9032549233 Enrollment ID: I20230501000370 |
| Provider Name | Johnathan Pierson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821526229 PECOS PAC ID: 5294077426 Enrollment ID: I20230501000707 |
| Provider Name | Zuleimye Valle Blas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306316906 PECOS PAC ID: 0143659805 Enrollment ID: I20230501000845 |
| Provider Name | Caitlyn D Fitzgerald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538781760 PECOS PAC ID: 4789006594 Enrollment ID: I20230501001717 |
| Provider Name | Sitwat Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376004556 PECOS PAC ID: 4183967961 Enrollment ID: I20230501001897 |
| Provider Name | Modupeoluwa Omolola Babalola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619530888 PECOS PAC ID: 8426479387 Enrollment ID: I20230501002046 |
| Provider Name | Lorelys Arroyo Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114553120 PECOS PAC ID: 0244651149 Enrollment ID: I20230501002287 |
| Provider Name | Joseph Harwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154070068 PECOS PAC ID: 3971956046 Enrollment ID: I20240125002124 |
| Provider Name | Aleksandra V Grabb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366182289 PECOS PAC ID: 9133572027 Enrollment ID: I20240126002506 |
| Provider Name | Carloyn Akin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245810142 PECOS PAC ID: 6608229521 Enrollment ID: I20240126003768 |
| Provider Name | Kaitlyn Elizabeth Halsema |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033790829 PECOS PAC ID: 9739524067 Enrollment ID: I20240227001357 |
| Provider Name | Luis M Hernandez Cobian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417427063 PECOS PAC ID: 3971948225 Enrollment ID: I20240227001900 |
| Provider Name | Heather Dockery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760253280 PECOS PAC ID: 0042655268 Enrollment ID: I20240228000158 |
| Provider Name | Natalie N Rivera Matos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295312791 PECOS PAC ID: 4789029927 Enrollment ID: I20240228000799 |
| Provider Name | Naomi S Gunadeva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376172890 PECOS PAC ID: 5395175459 Enrollment ID: I20240228001038 |
| Provider Name | Brenda Ned |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043066392 PECOS PAC ID: 7810430618 Enrollment ID: I20240621000875 |
| Provider Name | Angela Spivy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710650890 PECOS PAC ID: 2264975820 Enrollment ID: I20240624003630 |
| Provider Name | Morgan Flournoy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760630651 PECOS PAC ID: 1052855533 Enrollment ID: I20240626001951 |
| Provider Name | Jacob Debellis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245972116 PECOS PAC ID: 4789128802 Enrollment ID: I20240701001313 |
| Provider Name | Danielle Lidke-prow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780315218 PECOS PAC ID: 5799229811 Enrollment ID: I20240701001674 |
| Provider Name | Lea Hunter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689897449 PECOS PAC ID: 3870037898 Enrollment ID: I20240702000749 |
| Provider Name | Jeffrey Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548947435 PECOS PAC ID: 0648714667 Enrollment ID: I20240702000903 |
| Provider Name | Michael Boring |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831831619 PECOS PAC ID: 6608310578 Enrollment ID: I20240702003153 |
| Provider Name | Youngmin Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932841103 PECOS PAC ID: 5294270500 Enrollment ID: I20240711000384 |
| Provider Name | Nisha G Beard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023759198 PECOS PAC ID: 6002352085 Enrollment ID: I20240725004715 |
| Provider Name | Christopher Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801594742 PECOS PAC ID: 2860939535 Enrollment ID: I20240731002141 |
| Provider Name | Taylor H Allen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457863557 PECOS PAC ID: 4789123746 Enrollment ID: I20240822002061 |
| Provider Name | Kourtney Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386404630 PECOS PAC ID: 1951836493 Enrollment ID: I20241121000659 |
| Provider Name | Anzola Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154092245 PECOS PAC ID: 3173912342 Enrollment ID: I20241121001317 |
| Provider Name | Blake Dallon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346944766 PECOS PAC ID: 3577098987 Enrollment ID: I20241121004149 |
| Provider Name | Jessica Cauthen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114629011 PECOS PAC ID: 8628503034 Enrollment ID: I20241121004311 |
| Provider Name | Abigail Williamson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245967009 PECOS PAC ID: 3779018189 Enrollment ID: I20241121004521 |
| Provider Name | Alricka Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225664212 PECOS PAC ID: 5496280810 Enrollment ID: I20241121004656 |
| Provider Name | George Butler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154063808 PECOS PAC ID: 9133654569 Enrollment ID: I20241122000129 |
| Provider Name | Makala Mangram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952115743 PECOS PAC ID: 6800387424 Enrollment ID: I20251112000384 |
| Provider Name | Kristen Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659959658 PECOS PAC ID: 9335629583 Enrollment ID: I20260217000770 |
| Provider Name | Angela Hennessee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326903527 PECOS PAC ID: 5890275853 Enrollment ID: I20260218000594 |
| Provider Name | Lisa Llanas Hagberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831139377 PECOS PAC ID: 3476467002 Enrollment ID: I20260223002626 |
| Provider Name | Aryana Misaghi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538862537 PECOS PAC ID: 3779064258 Enrollment ID: I20260223002862 |
| Provider Name | Aaron Nettles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447952718 PECOS PAC ID: 1557842085 Enrollment ID: I20260224000099 |
| Provider Name | Michelle Mercer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891436036 PECOS PAC ID: 3375922362 Enrollment ID: I20260224000209 |
| Provider Name | Abhiram Srivatsa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033835392 PECOS PAC ID: 3971084401 Enrollment ID: I20260224000310 |
| Provider Name | Andrea Elam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932496320 PECOS PAC ID: 6406338995 Enrollment ID: I20260304001921 |
| Provider Name | Eiesha Porter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225929631 PECOS PAC ID: 7012499536 Enrollment ID: I20260304002404 |
| Provider Name | Jessica Ray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518652536 PECOS PAC ID: 8820570112 Enrollment ID: I20260305001778 |
| Provider Name | Chris-nadege Saintelus Almonord |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275343287 PECOS PAC ID: 8527541200 Enrollment ID: I20260311001065 |
Steven Forrest Cowan Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1421 Lee St, Brunswick, GA 31520 Phone: 912-265-0007 Fax: 912-261-0593 |
Coastal Neurology and Neurosurgery Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Starling St, Suite 506, Brunswick, GA 31520 Phone: 912-264-9670 Fax: 912-264-9671 |
Maria C. Coughenour LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2318 Heron St, Brunswick, GA 31520 Phone: 912-265-7660 Fax: 912-265-7858 |
The Resiliency Institute, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 706 G St, Suite 101, Brunswick, GA 31520 Phone: 912-450-9700 |
New Beginnings Mental Health and Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3441 Cypress Mill Rd Ste 101, Brunswick, GA 31520 Phone: 912-275-4763 Fax: 912-216-3668 |
Alina M Galliano PC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 G St, Brunswick, GA 31520 Phone: 912-554-0811 Fax: 912-554-0763 |