| Psychogenesis, Inc. | |
|
519 Broad St Suite 202 Rome GA 30161-1734 | |
| (706) 232-5544 | |
| (888) 543-1173 |
| Full Name | Psychogenesis, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 519 Broad St, Rome, Georgia |
| Authorized Official Name and Position | Judith Tutin (PRESIDENT) |
| Authorized Official Contact | 7062325544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychogenesis, Inc. 2 Windsor Rd Sw Rome GA 30165-8555 Ph: (706) 232-5544 | Psychogenesis, Inc. 519 Broad St Suite 202 Rome GA 30161-1734 Ph: (706) 232-5544 |
| NPI Number | 1083779763 |
|---|---|
| Provider Enumeration Date | 12/24/2006 |
| Last Update Date | 12/03/2015 |
| Medicare PECOS PAC ID | 0547435182 |
|---|---|
| Medicare Enrollment ID | O20111212000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083779763 | NPI | - | NPPES |
| 000728923A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2075 (Georgia) | Primary |
| Provider Name | Judith Tutin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265597942 PECOS PAC ID: 0446425987 Enrollment ID: I20111212000096 |
Highland Rivers Community Service Board Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 96 Alford Rd Se, Rome, GA 30161 Phone: 706-270-5033 Fax: 706-370-7749 | |
Floyd Healthcare Management Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 306 Shorter Ave Nw, Rome, GA 30165 Phone: 706-509-3500 Fax: 706-509-4791 | |
Balanced Living Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 412 E 1st St, Rome, GA 30161 Phone: 706-509-0130 Fax: 706-237-6503 | |
Behavior Momentum Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Acadia Dr Nw, Rome, GA 30165 Phone: 706-676-6689 | |
Redmond Hospital Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Redmond Rd Nw, Rome, GA 30165 Phone: 706-734-7643 Fax: 706-734-7356 | |
Lavender Mountain Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 Bridgepoint Plz Ste 120, Rome, GA 30161 Phone: 706-450-4029 Fax: 706-810-4029 | |
Highland Rivers Csb Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1838 Redmond Cir Nw Ste E, Rome, GA 30165 Phone: 706-622-2322 |