DR. MARK J. PRIGATANO (NPI# 1063420875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063420875 |
| Entity Type | Individual |
| Full Name | DR. MARK J. PRIGATANO |
| Credential | PH.D. |
| Practice Address |
146 Pierce Ave Macon GA 31204-2871 |
| Practice Telephone | 4787462333 |
| Practice Fax Number | 4788454493 |
| Mailing Telephone | 4787462333 |
| Mailing Fax Number | 4788454493 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2014-03-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY001999 | GA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY001999 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000730254C | 05 |
| Street Address |
146 PIERCE AVE |
| City | MACON |
| State | GA |
| Zip Code | 31204-2871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857618 | Life Solutions Counseling Services, LLC | Social Worker | 146 Pierce Ave, Macon, GA 31204-2871 | 2019-12-03 |
| 1467673350 | Mark J. Prigatano, Ph.d. | Psychologist | 146 Pierce Ave, Macon, GA 31204-2871 | 2007-05-01 |
| 1639227051 | Sonja Norris Ridlehoover | Marriage & Family Therapist | 146 Pierce Ave, Macon, GA 31204-2871 | 2007-01-08 |
| 1629081526 | Donna Purvis Ivey | Psychologist | 146 Pierce Ave, Macon, GA 31204-2871 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775085 | Amy Lynn Miller | Counselor | 890 Northwoods Plaza/burrus Road, Macon, GA 31204 | 2018-10-04 |
| 1275056566 | Kenyada Moss | Counselor | 762 Thurmond Dr., Macon, GA 31204 | 2017-07-19 |
| 1508303876 | Amber Foster | Counselor | 890 Northwoods Plaza, Macon, GA 31204 | 2017-01-25 |
| 1952757585 | Sarah Vanselous Spencer | Speech-Language Pathologist | 2720 Sheraton Dr # D-140, Macon, GA 31204 | 2016-05-12 |
| 1952706343 | Matthew Wayne Frazier | Pharmacist | 4260 Log Cabin Dr, Macon, GA 31204 | 2014-10-28 |
| 1215338587 | Sharon Yvette Flewellen | Licensed Practical Nurse | 1876 Moore Street, Macon, GA 31204 | 2014-09-05 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1821439811 | Irene Gung Ho | Physician Assistant | 3203 Vineville Ave Ste A, Macon, GA 31204 | 2013-07-08 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1255599346 | Methodist Home of The South Georgia Conference, Inc. | Voluntary or Charitable | 304 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| Find all providers in zip 31204 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174864979 | Kenwana Michelle Vanderbilt | Psychologist | Macon Outpatient Clinic- 5398 Thomaston Rd., Suite B, Macon, GA 31220 | 2013-03-05 |
| 1073833638 | Michael R Johns Psyd | Psychologist | 3678 Vineville Ave, Macon, GA 31204-1868 | 2010-06-07 |
| 1710024385 | Melissa Hicks | Psychologist | 6601 Zebulon Rd, Macon, GA 31220-7606 | 2007-01-31 |
| 1174679062 | Stacey Smoot Owen | Psychologist | 5398 Thomaston Rd, Suite B, Macon, GA 31220-8110 | 2007-01-25 |
| 1902969363 | Jal Psychological Services | Psychologist | 3626 Vineville Ave, Macon, GA 31204-1853 | 2006-12-18 |
| 1801983325 | Steven Alan Hobbs | Psychologist | 655 1st St, Macon, GA 31201-2852 | 2006-10-06 |
| 1407488968 | Christina Lynn Charette | Psychologist | 4931 Riverside Dr # 400a, Macon, GA 31210-1156 | 2020-02-12 |
| 1801319447 | Neha Khorana | Psychologist | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2017-07-25 |
| 1154602910 | Dinah K Ayna | Psychologist | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2011-09-07 |
| 1548588825 | Jeffrey A Wilson-reese | Psychologist | 4600 Fulton Mill Rd, Central S.p. Mental Health Dept., Macon, GA 31208-2500 | 2010-05-11 |
| Find all providers in MACON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.