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General NPI Number Information
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NPI Number | 1265339337
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Entity Type | Organization
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Legal Business Name | NEW MERCY FAMILY SUPPORT TEAM
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Dates
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Enumeration Date | 10/22/2026
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Last Update Date | 10/22/2026
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Provider Practice Location Address
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Address Line | 2904 MACON RD
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City | COLUMBUS
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State | GA
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Zip | 31906-2204
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Country | US
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Telephone | 706-573-8282
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Fax |
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Provider Business Mailing Address
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Address Line | 2904 MACON RD
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City | COLUMBUS
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State | GA
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Zip | 31906-2204
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Country | US
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Telephone | 706-573-8282
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MICKINA B AVERETT-BROOKS
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Credential | LMSW
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Telephone | 706-573-8282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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