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General NPI Number Information
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NPI Number | 1477680973
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Entity Type | Organization
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Legal Business Name | SOUTH GEORGIA PSYCHIATRIC & COUNSELING CENTER
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2704 N OAK ST BUILDING B-3
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City | VALDOSTA
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State | GA
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Zip | 31602-1744
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Country | US
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Telephone | 229-257-0100
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Fax | 229-257-0050
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Provider Business Mailing Address
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Address Line | 2704 N OAK ST BUILDING B-3
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City | VALDOSTA
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State | GA
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Zip | 31602-1744
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Country | US
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Telephone | 229-257-0100
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Fax | 229-257-0050
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CAROL SHEFFIELD
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Credential |
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Telephone | 229-257-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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