| Georgia Behavioral Services, Llc | |
|
104 Borders Way Ste 500 Warner Robins GA 31088-8967 | |
| (478) 352-0422 | |
| (888) 813-6815 |
| Full Name | Georgia Behavioral Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 104 Borders Way Ste 500, Warner Robins, Georgia |
| Authorized Official Name and Position | Darla Nicole Jackson (CEO) |
| Authorized Official Contact | 4783520422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Behavioral Services, Llc 104 Borders Way Ste 500 Warner Robins GA 31088-8967 Ph: (910) 689-5190 | Georgia Behavioral Services, Llc 104 Borders Way Ste 500 Warner Robins GA 31088-8967 Ph: (478) 352-0422 |
| NPI Number | 1861931172 |
|---|---|
| Provider Enumeration Date | 02/20/2017 |
| Last Update Date | 02/21/2019 |
| Medicare PECOS PAC ID | 3072845692 |
|---|---|
| Medicare Enrollment ID | O20191031002699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861931172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1083 (Georgia) | Primary |
| Provider Name | Wayne H Welch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578881538 PECOS PAC ID: 6608045604 Enrollment ID: I20110809000260 |
| Provider Name | Kristopher Sutter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982876710 PECOS PAC ID: 3870873334 Enrollment ID: I20161129002779 |
| Provider Name | Briana Manley Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780168203 PECOS PAC ID: 6002244498 Enrollment ID: I20200318001160 |
| Provider Name | Kendal Harrod |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386331767 PECOS PAC ID: 5294183505 Enrollment ID: I20231128000625 |
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