TMC-BEHAVIORAL HEALTH OF WEST GEORGIA (NPI# 1356795462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356795462 |
| Entity Type | Organization |
| Organization Name | TMC-BEHAVIORAL HEALTH OF WEST GEORGIA |
| Other Organization Name | BEHAVIORAL HEALTH OF WEST GEORGIA |
| Practice Address |
101 Quartz Dr Ste 103 Villa Rica GA 30180-3255 |
| Mailing Address |
119 Ambulance Dr Suite 202 Carrollton GA 30117-3857 |
| Practice Telephone | 7708123530 |
| Practice Fax Number | 7708123531 |
| Mailing Telephone | 7708388710 |
| Mailing Fax Number | 7708388563 |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2019-08-27 |
| Authorized Official Name | CAROL CREWS (CFO) |
| Authorized Official Telephone | 7708388302 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Behavioral Health of West Georgia | Doing Business As Name - Organization |
| Street Address |
101 QUARTZ DR STE 103 |
| City | VILLA RICA |
| State | GA |
| Zip Code | 30180-3255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821045402 | Debora A Lamonica | Psychiatry & Neurology | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2006-05-28 |
| 1851937726 | El Janeo D Vereen | Counselor | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2019-11-25 |
| 1871140798 | John Charles Wood | Nurse Practitioner | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2019-08-26 |
| 1184180069 | Sarah Joann Matheka | Nurse Practitioner | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2019-02-15 |
| 1679097893 | Yonas Tamene | Nurse Practitioner | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2017-07-30 |
| 1053765057 | Phuongtam Nguyen | Psychiatry & Neurology | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2016-04-16 |
| 1699130500 | Tabitha Wanjiku | Nurse Practitioner | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2015-12-18 |
| 1295134492 | April Jiles Fortenberry | Nurse Practitioner | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2014-08-14 |
| 1174934384 | Avjola Hoxha | Psychiatry & Neurology | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2014-05-12 |
| 1437416286 | Ashaki Eva Warren | Psychiatry & Neurology | 101 Quartz Dr Ste 103, Villa Rica, GA 30180-3255 | 2012-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174161624 | Crucible Communication Therapy LLC | Speech-Language Pathologist | 9765 Walnut Grove Trail, Villa Rica, GA 30180 | 2019-12-16 |
| 1366802845 | Medic-pearl, LLC | Ambulance | 1108 Charter Oak Ct, Villa Rica, GA 30180 | 2016-02-26 |
| 1396138368 | Josette Etienne | Nurse Practitioner | 403 Permian Way Suite A, Villa Rica, GA 30180 | 2015-03-13 |
| 1447690516 | Judith L.m. Thigpen | Nurse Practitioner | 736 Highway 78 West, Minute Clinic, Villa Rica, GA 30180 | 2013-07-03 |
| 1477890168 | Wesley Douglas Mckenzie | Pharmacist | 2500 Mirror Lake Blvd, Villa Rica, GA 30180 | 2013-01-15 |
| 1497005359 | Malika Remie Rajendra | Optometrist | 600 Hwy 61, Villa Rica, GA 30180 | 2012-09-18 |
| 1972876449 | Catherine Elaine Tyson | Pharmacist | 601 Dallas Road, Villa Rica, GA 30180 | 2012-02-14 |
| 1619262433 | Villa Rica Rx LLC | Pharmacy | 222 West Wilson Street, Villa Rica, GA 30180 | 2011-06-09 |
| 1851602874 | Jules Chopin Sybert | Nurse Practitioner | 736 W. Bankhead Hwy, Villa Rica, GA 30180 | 2010-06-24 |
| 1487984019 | Lisa Wood | Occupational Therapy Assistant | 1207 Woods Walk, Villa Rica, GA 30180 | 2010-01-04 |
| Find all providers in zip 30180 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548513211 | Salveo Integrative Health | Psychiatry & Neurology | 301 Gwinnett Dr., Lawrenceville, GA 30046 | 2012-10-18 |
| 1821386855 | Outreach Psychiatric Associates, LLC | Psychiatry & Neurology | 250 Constitution Blvd, Ste 203, Lawrenceville, GA 30046-8432 | 2011-07-12 |
| 1336324144 | Leo O Noragbon | Psychiatry & Neurology | 728 Nightwind Way, Stockbridge, GA 30281-9134 | 2007-12-31 |
| 1457535155 | Michael S Conley M.d., P.C. | Psychiatry & Neurology | 285 Boulevard Ne Ste 315, Atlanta, GA 30312-4213 | 2007-12-18 |
| 1508087792 | Psychiatric Services of America | Psychiatry & Neurology | 311 Gwinnett Dr., Lawrenceville, GA 30046 | 2007-05-02 |
| 1184706996 | Jae Pak PC | Psychiatry & Neurology | 2160 Fountain Drive, 200, Snellville, GA 30078-6783 | 2006-10-20 |
| 1194811174 | Adriana P Hermida | Psychiatry & Neurology | 826 Fieldstone Pkwy, Jonesboro, GA 30236-7500 | 2006-10-05 |
| 1689765844 | William Maffitt Mcdonald | Psychiatry & Neurology | Emory Division of Geriatric Psychiatry, Wesley Woods Health Center, 1841 Clifton Road Ne, Atlanta, GA 30329 | 2006-09-27 |
| 1760405211 | Frank Wayne Brown | Psychiatry & Neurology | 1899 E Gate Dr, Stone Mountain, GA 30087-1912 | 2006-07-25 |
| 1740280551 | Jae H Pak | Psychiatry & Neurology | 2160 Fountain Dr, Suite 200, Snellville, GA 30078-7022 | 2005-07-22 |
| Find all providers with the same taxonomy | ||||
| City | VILLA RICA |
| Zip Code | 30180 |
Please comment or provide details below to improve the information on TMC-BEHAVIORAL HEALTH OF WEST GEORGIA.
| 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.