| Madison Fields Lpc Llc | |
|
112 Parker Ave S Brooklet GA 30415-8208 | |
| (912) 712-1712 | |
| Not Available |
| Full Name | Madison Fields Lpc Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 112 Parker Ave S, Brooklet, Georgia |
| Authorized Official Name and Position | Madison Fields (PRACTICE OWNER) |
| Authorized Official Contact | 9127121712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Fields Lpc Llc Po Box 95 Brooklet GA 30415-0095 Ph: (912) 712-1712 | Madison Fields Lpc Llc 112 Parker Ave S Brooklet GA 30415-8208 Ph: (912) 712-1712 |
| NPI Number | 1265361455 |
|---|---|
| Provider Enumeration Date | 05/14/2026 |
| Last Update Date | 05/14/2026 |
| Certification Date | 05/14/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265361455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Circle Of Hands Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 110 Parker Ave S, Brooklet, GA 30415 Phone: 706-490-2555 Fax: 912-823-4232 |