FULTON COUNTY MENTAL HEALTH CENTER (NPI# 1437299625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437299625 |
| Entity Type | Organization |
| Organization Name | FULTON COUNTY MENTAL HEALTH CENTER |
| Practice Address |
475 Fairburn Rd Sw Atlanta GA 30331-1907 |
| Practice Telephone | 4046919627 |
| Practice Fax Number | 4046919793 |
| Mailing Telephone | 4046919627 |
| Mailing Fax Number | 4046919793 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ERNEST EGLEN III (THERAPIST) |
| Authorized Official Telephone | 4046919627 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | CSW003136 | GA | Agencies |
| Street Address |
475 FAIRBURN RD SW |
| City | ATLANTA |
| State | GA |
| Zip Code | 30331-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407861149 | Ernest Eglen IIi | Social Worker | 475 Fairburn Rd Sw, Atlanta, GA 30331-1907 | 2006-07-30 |
| 1285700682 | Fulton County Mhddad | Community/Behavioral Health | 475 Fairburn Rd Sw, Atlanta, GA 30331-1907 | 2006-11-28 |
| 1518069574 | Juliette Wilkinson Mcgaha | Registered Nurse | 475 Fairburn Rd Sw, Atlanta, GA 30331-1907 | 2006-09-01 |
| 1134138886 | Kassandra Miller | Pharmacist | 475 Fairburn Rd Sw, Atlanta, GA 30331-1907 | 2006-08-05 |
| 1558379867 | Augusta H Olatidoye | Counselor | 475 Fairburn Rd Sw, Atlanta, GA 30331-1907 | 2006-08-03 |
| 1386650034 | Patricia J Knowles | Licensed Practical Nurse | 475 Fairburn Rd Sw, Atlanta, GA 30331-1907 | 2006-08-01 |
| 1396750824 | Rubbie Lee London Major | Registered Nurse | 475 Fairburn Rd Sw, Atlanta, GA 30331-1907 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1982237400 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5829 Campbellton Road, S.w, Suite 110, Atlanta, GA 30331 | 2020-02-13 |
| 1295375558 | Drusilla Precious Cudjoe | Behavior Technician | 3800 Camp Creek Parkway Sw, Building 1400, Atlanta, GA 30331 | 2020-01-14 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1033629779 | Carmen Ardoin | Counselor | 2636 Martin Luther King Jr. Drive, Suite 12, Atlanta, GA 30331 | 2017-10-09 |
| 1346759974 | Neva R Allison | Nurse Practitioner | 2611 Dayview Ln, Atlanta, GA 30331 | 2017-09-26 |
| 1538678255 | Natalie Mckay | Technician/Technologist | 3915 Cascade Rd, 220, Atlanta, GA 30331 | 2017-09-26 |
| 1700304268 | Tyrone Pipkin | Contractor | 415 Kendrick Terrace Sw, Atlanta, GA 30331 | 2017-09-05 |
| 1073031688 | Kristen Wooldridge | Pharmacist | 3695 Cascade Road, Atlanta, GA 30331 | 2017-09-04 |
| 1548704687 | Advance Pain Management | Health Maintenance Organization | 2950 Stone Hogan Road Connector, Atlanta, GA 30331 | 2016-12-08 |
| Find all providers in zip 30331 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952914632 | Brighter Dayz, Incorporated | Community/Behavioral Health | 1016 Howell Mill Rd Nw Apt 4408, Atlanta, GA 30318-5592 | 2020-08-24 |
| 1699387688 | Rise Rehabilitation Services, LLC | Community/Behavioral Health | 738 Highland Park Trl, Atlanta, GA 30350-6706 | 2020-08-20 |
| 1700427820 | Trust2change, LLC. | Community/Behavioral Health | 2900 Chamblee Tucker Rd Bldg 8, Atlanta, GA 30341-4100 | 2019-09-30 |
| 1538712088 | Ferris Healthcare Group | Community/Behavioral Health | 2900 Paces Ferry Rd Se Bldg C, Atlanta, GA 30339-5702 | 2019-07-23 |
| 1245890987 | Soc Integrated Services, LLC | Community/Behavioral Health | 130 Wynfield Way Sw, Atlanta, GA 30331-6837 | 2019-06-15 |
| 1770046740 | Z-one Incorporated | Community/Behavioral Health | 505 Tufton Trl Se, Atlanta, GA 30354-2867 | 2019-04-08 |
| 1003377086 | Chris 180, Inc. | Community/Behavioral Health | 3700 Martin Luther King Dr Sw, Atlanta, GA 30331-3674 | 2019-03-30 |
| 1144790783 | Danielle Smith | Community/Behavioral Health | 880 Glenwood Ave Se Unit 3185, Atlanta, GA 30316-1955 | 2018-11-27 |
| 1073083762 | Michael Pollock | Community/Behavioral Health | 3725 Princeton Lakes Pkwy Sw Apt 7003, Atlanta, GA 30331-5560 | 2018-11-26 |
| 1851881353 | Atlanta Life Journeys Services, LLC | Community/Behavioral Health | 3196 Dogwood Dr, Atlanta, GA 30354-1149 | 2018-05-10 |
| Find all providers in ATLANTA | ||||
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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.