| Middle Flint Area Community Service Board | |
|
410 E Church St Fort Valley GA 31030-3097 | |
| (478) 825-6499 | |
| Not Available |
| Full Name | Middle Flint Area Community Service Board |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 410 E Church St, Fort Valley, Georgia |
| Authorized Official Name and Position | Margaret Jordan (RCM MANAGER) |
| Authorized Official Contact | 2298155286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middle Flint Area Community Service Board Po Box 1348 Americus GA 31709-1348 Ph: (229) 815-5454 | Middle Flint Area Community Service Board 410 E Church St Fort Valley GA 31030-3097 Ph: (478) 825-6499 |
| NPI Number | 1366521932 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Medicare PECOS PAC ID | 3274426150 |
|---|---|
| Medicare Enrollment ID | O20040204000828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366521932 | NPI | - | NPPES |
| 000604502B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Georgia) | Primary |
| Provider Name | Jaymal R. Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962433599 PECOS PAC ID: 3779474010 Enrollment ID: I20040324000650 |
| Provider Name | Marsha E Kinnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538110598 PECOS PAC ID: 0547238925 Enrollment ID: I20040923000143 |
| Provider Name | Eric C Fan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629191663 PECOS PAC ID: 6507826302 Enrollment ID: I20041015000600 |
| Provider Name | Michelle B Fan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437272796 PECOS PAC ID: 6204896988 Enrollment ID: I20041018000054 |
| Provider Name | Wallace D Mays |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881667988 PECOS PAC ID: 2264474725 Enrollment ID: I20050527000005 |
| Provider Name | Kenneth E Dinella |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992921126 PECOS PAC ID: 8022160639 Enrollment ID: I20090713000333 |
| Provider Name | Roseline A Makinde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902108491 PECOS PAC ID: 5193904506 Enrollment ID: I20110131000831 |
| Provider Name | Glendell B Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962755421 PECOS PAC ID: 4688826514 Enrollment ID: I20121128000649 |
| Provider Name | Cornelius C Grimes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710265145 PECOS PAC ID: 2062664709 Enrollment ID: I20121204000362 |
| Provider Name | Daniela L Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104232941 PECOS PAC ID: 7719107028 Enrollment ID: I20141009001101 |
| Provider Name | Nurul I Hoque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912109505 PECOS PAC ID: 2163597170 Enrollment ID: I20150708000183 |
| Provider Name | Michael Barrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497111207 PECOS PAC ID: 2062716723 Enrollment ID: I20160202001326 |
| Provider Name | Michayala K Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396288684 PECOS PAC ID: 1355625062 Enrollment ID: I20170224000502 |
| Provider Name | Megan W Alligood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225534670 PECOS PAC ID: 9335499292 Enrollment ID: I20180913003429 |
| Provider Name | Sheldon Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972985273 PECOS PAC ID: 8527376524 Enrollment ID: I20190814002780 |
| Provider Name | Danielle A Andrews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578081618 PECOS PAC ID: 2961769526 Enrollment ID: I20190827002563 |
| Provider Name | Marlanea Jarrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013501857 PECOS PAC ID: 3678973476 Enrollment ID: I20210616001271 |
| Provider Name | Kathleen A Yngayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386251452 PECOS PAC ID: 0941682892 Enrollment ID: I20220809001852 |
| Provider Name | Deepa Sobti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124058458 PECOS PAC ID: 3577564566 Enrollment ID: I20220822001183 |
| Provider Name | Chiamaka J Anosike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407594757 PECOS PAC ID: 5597132514 Enrollment ID: I20221104000330 |
| Provider Name | Kiana Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811630544 PECOS PAC ID: 4284084203 Enrollment ID: I20240103000294 |
| Provider Name | Benjamin Gatliff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316276645 PECOS PAC ID: 3779924071 Enrollment ID: I20240517001730 |
| Provider Name | Shonta Harper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154897296 PECOS PAC ID: 6800312414 Enrollment ID: I20250428001302 |
| Provider Name | Jacqueline C Ellis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417129859 PECOS PAC ID: 2163940636 Enrollment ID: I20250519001191 |
| Provider Name | Keyarta P Woodard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447972955 PECOS PAC ID: 4284153461 Enrollment ID: I20250521002868 |
| Provider Name | Jatara L Mason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265926927 PECOS PAC ID: 3577082510 Enrollment ID: I20250522002423 |
The Peach Pit Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1809 River Rd, Fort Valley, GA 31030 Phone: 478-827-3224 | |
The Regeneration Project Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 378 Tabor Rd, Fort Valley, GA 31030 Phone: 478-971-4684 | |
Exodus Consulting, Training & Wellness Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 College Ct, Fort Valley, GA 31030 Phone: 478-293-8503 | |
The Pinkney Counseling Group, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 E Main St, Fort Valley, GA 31030 Phone: 478-397-1471 | |
Dr. Wanda D. Hugget Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 Martin Luther King Jr Dr, Fort Valley, GA 31030 Phone: 478-216-8252 Fax: 478-845-0478 | |
Classroom21 Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 527 Railroad St, Fort Valley, GA 31030 Phone: 478-396-5489 |