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General NPI Number Information
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NPI Number | 1043439722
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1723 MILL ST
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City | AUGUSTA
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State | GA
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Zip | 30901-4083
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Country | US
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Telephone | 706-364-8683
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Fax | 706-364-8683
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Provider Business Mailing Address
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Address Line | 1723 MILL ST
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City | AUGUSTA
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State | GA
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Zip | 30901-4083
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Country | US
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Telephone | 706-364-8683
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Fax | 706-364-8683
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Authorized Official
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Title or Position | CEO
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Name | MS. KAY GRESHAM MORRISON
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Credential | MSW, LCSW, ACSW, MAC
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Telephone | 706-364-8683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 002457
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License Number State | GA
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