| Pineland Area Community Services Board | |
|
11 N College St Statesboro GA 30458-5306 | |
| (912) 764-9868 | |
| (912) 764-5066 |
| Full Name | Pineland Area Community Services Board |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 11 N College St, Statesboro, Georgia |
| Authorized Official Name and Position | Cynthia Cone-dekle (INTERIM CEO) |
| Authorized Official Contact | 9127646906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pineland Area Community Services Board Po Box 745 Statesboro GA 30459-0745 Ph: (912) 764-6906 | Pineland Area Community Services Board 11 N College St Statesboro GA 30458-5306 Ph: (912) 764-9868 |
| NPI Number | 1588735252 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 09/09/2025 |
| Certification Date | 09/09/2025 |
| Medicare PECOS PAC ID | 6002898616 |
|---|---|
| Medicare Enrollment ID | O20040607000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588735252 | NPI | - | NPPES |
| 000599343O | Medicaid | GA | |
| 000599343Z | Medicaid | GA | |
| 000622542AD | Medicaid | GA | |
| 000622542BB | Medicaid | GA | |
| 000622542J | Medicaid | GA | |
| 000720068D | Medicaid | GA | |
| 000981505A | Medicaid | GA | |
| 000622542AJ | Medicaid | GA | |
| 000622542AQ | Medicaid | GA | |
| 000622542AR | Medicaid | GA | |
| 000622542AV | Medicaid | GA | |
| 000622542B | Medicaid | GA | |
| 000720068A | Medicaid | GA | |
| 000720068K | Medicaid | GA | |
| 000720068O | Medicaid | GA | |
| 000599343Y | Medicaid | GA | |
| 000622542G | Medicaid | GA | |
| 000720068B | Medicaid | GA | |
| 000720068M | Medicaid | GA | |
| 000599343B | Medicaid | GA | |
| 000622542A | Medicaid | GA | |
| 000722147B | Medicaid | GA | |
| 000599343C | Medicaid | GA | |
| 000599343D | Medicaid | GA | |
| 000599343X | Medicaid | GA | |
| 000622542AH | Medicaid | GA | |
| 000622542AP | Medicaid | GA | |
| 000622542BA | Medicaid | GA | |
| 000599343A | Medicaid | GA | |
| 000599343AA | Medicaid | GA | |
| 000599343G | Medicaid | GA | |
| 000622542AI | Medicaid | GA | |
| 000622542AO | Medicaid | GA | |
| 000622542AU | Medicaid | GA | |
| 000720068L | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Michael A Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376504647 PECOS PAC ID: 9032015110 Enrollment ID: I20031210000006 |
| Provider Name | Ivy L Shuman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881693380 PECOS PAC ID: 6103818612 Enrollment ID: I20040402000147 |
| Provider Name | Joel S Bray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457467219 PECOS PAC ID: 8729082037 Enrollment ID: I20060829000157 |
| Provider Name | Thomas M Amburgey |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841254976 PECOS PAC ID: 1658409420 Enrollment ID: I20100514000782 |
| Provider Name | Reemon Bishara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750308623 PECOS PAC ID: 0042203606 Enrollment ID: I20101207000975 |
| Provider Name | Jennfier H Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083962849 PECOS PAC ID: 0749432110 Enrollment ID: I20121211000115 |
| Provider Name | Michael E Daly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659748077 PECOS PAC ID: 7012226822 Enrollment ID: I20151019000642 |
| Provider Name | Marianne A Mainer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861868481 PECOS PAC ID: 8426367061 Enrollment ID: I20151021001052 |
| Provider Name | Qian Tang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033657333 PECOS PAC ID: 3274817382 Enrollment ID: I20170308001564 |
| Provider Name | Swaroop Reddy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235363581 PECOS PAC ID: 7416285119 Enrollment ID: I20190819003888 |
| Provider Name | Alana P Waters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174000509 PECOS PAC ID: 5496129405 Enrollment ID: I20230314002504 |
| Provider Name | Nafiz Kalam Sheikh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740805852 PECOS PAC ID: 8921422833 Enrollment ID: I20230501002923 |
Erin Lawson Psy.d. Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Coach Lee Hill Blvd, Statesboro, GA 30458 Phone: 912-388-1312 | |
Hope, Faith And Resilience Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 Jordan Dr, Statesboro, GA 30458 Phone: 912-541-4968 | |
Skills For Life Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 226 S. Zetterower Ave., Statesboro, GA 30458 Phone: 912-681-3331 | |
Hope For Life Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Raleigh Ct, Statesboro, GA 30458 Phone: 912-225-6920 | |
Dps Health And Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Coach Lee Hill Blvd, Statesboro, GA 30458 Phone: 912-662-6501 Fax: 912-681-1012 | |
Roosevelt's Character Development Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 S College St, Statesboro, GA 30458 Phone: 912-541-2809 | |
Statesboro Psychiatric Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 Hill Pond Ln, Statesboro, GA 30458 Phone: 912-489-1629 Fax: 912-489-1630 |