SOUTHERN PSYCHOLOGICAL AND BEHAVIORAL SERVICES, LLC (NPI# 1164870408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164870408 |
| Entity Type | Organization |
| Organization Name | SOUTHERN PSYCHOLOGICAL AND BEHAVIORAL SERVICES, LLC |
| Other Organization Name | SPBS |
| Practice Address |
202 W Gordon St Suite D Valdosta GA 31601-4569 |
| Practice Telephone | 2294749800 |
| Practice Fax Number | 2295154443 |
| Mailing Telephone | 2294749800 |
| Mailing Fax Number | 2295154443 |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |
| Authorized Official Name | DR. TWYLA LUCINDA MANCIL (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 3527278679 |
| Authorized Official Credential | PH. D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY003935 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00316809A | 05 |
| Other Name | Type Code |
|---|---|
| SPBS | Other Name - Individual/Organization |
| Street Address |
202 W GORDON ST SUITE D |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31601-4569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447677828 | Twyla Lucinda Mancil | Psychologist | 202 W Gordon St, Suite D, Valdosta, GA 31601-4569 | 2014-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700838 | Tristan Carlos Garcia | Specialist/Technologist | 605 West Mary Street, Valdosta, GA 31601 | 2019-09-26 |
| 1508332438 | Euniqua Lashay Williams | Contractor | 812 Lausanne Drive, Valdosta, GA 31601 | 2018-10-18 |
| 1457847634 | Valencia Meshay Johnson | Contractor | 1211 North Oak Street, Valdosta, GA 31601 | 2018-07-10 |
| 1376038042 | Restoration Care Services, LLC | Home Health | 704 Lake Park Road, Valdosta, GA 31601 | 2018-06-26 |
| 1609373133 | Ikea Sharnay Calhoun | Contractor | 1710 Dedo Drive, Valdosta, GA 31601 | 2018-04-11 |
| 1174049431 | Alexious Denson | Contractor | 900 Blanton St., Apt A16, Valdosta, GA 31601 | 2017-08-18 |
| 1578012258 | Clarissa Yolanda Alderman | Counselor | 4107 N Forrest Run Circle, Valdosta, GA 31601 | 2016-09-23 |
| 1225322613 | Andrea J. Ramirez | Counselor | 1301 Melody Ln Ste B, Valdosta, GA 31601 | 2011-06-03 |
| 1316248560 | L&r Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Sharper Circle, Valdosta, GU 31601 | 2010-11-04 |
| 1902121809 | Grace Healthcare Services Inc | Respite Care | 1010 Slater Street, Valdosta, GA 31601 | 2010-04-02 |
| Find all providers in zip 31601 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771876 | Aldo Enrique Revilla | Psychologist | Bermiss Rd, Moody Afb, Valdosta, GA 31699 | 2017-10-13 |
| 1588194799 | Ryan Couillou | Psychologist | 2704 N Oak St Bldg A1, Valdosta, GA 31602-5901 | 2017-06-20 |
| 1447677828 | Twyla Lucinda Mancil | Psychologist | 202 W Gordon St, Suite D, Valdosta, GA 31601-4569 | 2014-03-24 |
| 1881874618 | Kellie Hyde | Psychologist | 5140 Northwind Blvd, Condo 305 East, Valdosta, GA 31605-4506 | 2007-11-08 |
| 1720003262 | David Thomas Wasieleski | Psychologist | 1002 Slater St, Valdosta, GA 31601-3937 | 2006-07-13 |
| 1790240984 | Jennifer Michelle Branscome | Psychologist | 2236 Bemiss Rd, Valdosta, GA 31602-1942 | 2019-02-01 |
| 1750632279 | Palmtree Psychological Services, LLC | Psychologist | 111 Woodrow Wilson Dr, Suite B, Valdosta, GA 31602-2587 | 2012-09-24 |
| 1225366172 | Marcie C Wiseman | Psychologist | 2704 N Oak St, Building B-3, Valdosta, GA 31602-1744 | 2009-12-03 |
| 1962516625 | Emily Burton | Psychologist | 2841 N Patterson St, Valdosta, GA 31602-1743 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568072015 | Karen A Foster | Psychologist | 2115 Dee Dee Muse Ln Nw, Atlanta, GA 30318-1503 | 2020-08-08 |
| 1013525120 | Renato Popovic | Psychologist | 2601 Cross Country Dr, Columbus, GA 31906-1801 | 2020-07-15 |
| 1275159584 | Joe Ann Marie Brandt | Psychologist | 11706 Mercy Blvd Ste 1, Savannah, GA 31419-1751 | 2020-06-23 |
| 1376164863 | Alexander Brikman | Psychologist | 2374 Main St Ste A, Tucker, GA 30084-4533 | 2020-05-06 |
| 1154942084 | Martie Camille Belle | Psychologist | 1462 Clifton Rd Ne Ste 235, Atlanta, GA 30322-1063 | 2020-05-01 |
| 1518513738 | Narjerah Delk | Psychologist | 1226 Anchor Ter Sw, Atlanta, GA 30311-3402 | 2019-08-13 |
| 1043862907 | Lauren Barbara Mcsweeney | Psychologist | 12 Executive Park Dr Ne Ste 3000, Atlanta, GA 30329-2206 | 2019-07-11 |
| 1356907695 | Mc Medical LLC | Psychologist | 3615 Charles Hardy Pkwy Ste 200, Dallas, GA 30157-9472 | 2019-05-13 |
| 1851853758 | Charles A Helm | Psychologist | 116 Preston Landing Cir, Lithia Springs, GA 30122-6846 | 2019-04-01 |
| 1194285106 | Heather Ansari | Psychologist | 3715 Northside Pkwy Nw Ste 605, Atlanta, GA 30327-2886 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
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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.