| The Samaritan Counseling Center Of Southwest Georgia | |
|
208 S Broad St Bainbridge GA 39817-3616 | |
| (229) 243-1633 | |
| (229) 243-9446 |
| Full Name | The Samaritan Counseling Center Of Southwest Georgia |
|---|---|
| Speciality | Counselor |
| Location | 208 S Broad St, Bainbridge, Georgia |
| Authorized Official Name and Position | Chris Beam (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2292431633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Samaritan Counseling Center Of Southwest Georgia Po Box 1276 Bainbridge GA 39818-1276 Ph: (229) 243-1633 | The Samaritan Counseling Center Of Southwest Georgia 208 S Broad St Bainbridge GA 39817-3616 Ph: (229) 243-1633 |
| NPI Number | 1669651212 |
|---|---|
| Provider Enumeration Date | 10/31/2007 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/26/2024 |
| Medicare PECOS PAC ID | 1557628336 |
|---|---|
| Medicare Enrollment ID | O20171204000887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669651212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC004327 (Georgia) | Primary |
| Provider Name | Chris A Beam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770608952 PECOS PAC ID: 6002173887 Enrollment ID: I20240309000214 |
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