Healthcare Provider Details

I. General information

NPI: 1619780392
Provider Name (Legal Business Name): AUGUSTA PSYCHIATRY AND THERAPY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 04/05/2025
Certification Date: 04/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3665 WHEELER RD STE 1A
AUGUSTA GA
30909-6596
US

IV. Provider business mailing address

762 OXFORD RD
AUGUSTA GA
30909-3248
US

V. Phone/Fax

Practice location:
  • Phone: 706-825-4691
  • Fax:
Mailing address:
  • Phone: 706-831-7824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. PAMELA P RINKER
Title or Position: OWNER
Credential:
Phone: 706-831-7824