| Peachford Behavioral Health System of Atlanta | |
|
2151 Peachford Rd Atlanta GA 30338-6534 | |
| (770) 455-3200 | |
| (770) 454-2349 |
| Full Name | Peachford Behavioral Health System of Atlanta |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2151 Peachford Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Steve Filton (SVP) |
| Authorized Official Contact | 8003477750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peachford Behavioral Health System of Atlanta 367 S Gulph Rd Attn. Patti Jones King Of Prussia PA 19406-3121 Ph: (610) 768-3359 | Peachford Behavioral Health System of Atlanta 2151 Peachford Rd Atlanta GA 30338-6534 Ph: (770) 455-3200 |
| NPI Number | 1124207220 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 03/27/2015 |
| Medicare PECOS PAC ID | 9234123894 |
|---|---|
| Medicare Enrollment ID | O20040414001376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124207220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 044-596 (Georgia) | Primary |
| Provider Name | Mark Craton Hutto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699844159 PECOS PAC ID: 1951575646 Enrollment ID: I20111115000204 |
| Provider Name | John C Leach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386902856 PECOS PAC ID: 2163748773 Enrollment ID: I20221027003306 |
| Provider Name | Valentina Asamaigor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598347106 PECOS PAC ID: 4284090564 Enrollment ID: I20230510003493 |
| Provider Name | Amanda a Hendricks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982354551 PECOS PAC ID: 5890175285 Enrollment ID: I20241010003384 |
| Provider Name | Jackie Marshall-martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245743756 PECOS PAC ID: 1153855804 Enrollment ID: I20241118001120 |
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