THE FERN CENTER FOR LIFE (NPI# 1477111334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477111334 |
| Entity Type | Organization |
| Organization Name | THE FERN CENTER FOR LIFE |
| Practice Address |
158 Moreland Ave Se Atlanta GA 30316-1676 |
| Mailing Address |
1624 Newton Ave Se Atlanta GA 30316-2116 |
| Practice Telephone | 4046944205 |
| Practice Fax Number | 8777598014 |
| Mailing Telephone | 4046944205 |
| Mailing Fax Number | 8777598014 |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-06-04 |
| Authorized Official Name | CHRISTINA GRANGE (CEO) |
| Authorized Official Telephone | 4046944205 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | LICENSE | 003766 | 01 |
| Street Address |
158 MORELAND AVE SE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30316-1676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156923 | Rakiya Williams | Counselor | 1030 Fayetteville Rd., Atlanta, GA 30316 | 2019-10-23 |
| 1215585815 | Madison Victoria Baugh | Counselor | Chris180, 1030 Fayetteville Rd, Atlanta, GA 30316 | 2019-08-28 |
| 1265089460 | Josee Dominque Muldrew | Counselor | 1030 Fayetteville Rd. Se, Atlanta, GA 30316 | 2019-08-22 |
| 1255984241 | Monique Overstreet | Counselor | 1030 Fayetteville Road, Atlanta, GA 30316 | 2019-07-19 |
| 1023573979 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 905 Memorial Drive Se, Atlanta-fulton, GA 30316 | 2019-02-05 |
| 1740726454 | Jimmy Brian Sambula | Behavior Technician | 1017 Fayetteville Rd. Se, Atlanta, GA 30316 | 2017-01-19 |
| 1033665039 | Liberty Group Senior Services | Clinic/Center | 1879 Glenwood Avenue, Atlanta, GA 30316 | 2016-08-30 |
| 1043673650 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 800 Glenwood Ave Se, Atlanta, GA 30316 | 2016-03-31 |
| 1992143382 | Ayodele Osasona | Surgery | 2004 Oak Terrace Dr Se, Atlanta, GA 30316 | 2013-06-07 |
| 1891945721 | Denise Renee Cagle | Social Worker | 1471 Town Country Dr Se, Atlanta, GA 30316 | 2008-09-28 |
| Find all providers in zip 30316 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140386 | The Worth, Wisdom, and Wellness Center LLC | Psychologist | 1201 W Peachtree St Nw Ste 2330, Atlanta, GA 30309-3453 | 2020-09-23 |
| 1972141323 | Valerie Victoria Cuffee | Psychologist | 400 W Peachtree St Nw Ste 4, Atlanta, GA 30308-3534 | 2019-12-17 |
| 1861964793 | Franco Dispenza | Psychologist | 805 Peachtree St Ne Unit 410, Atlanta, GA 30308-6015 | 2018-12-17 |
| 1144688599 | Andrew Adelman | Psychologist | 814 Juniper St Ne Ste 201, Atlanta, GA 30308-1300 | 2016-01-31 |
| 1164767612 | Roslyn M Harden Scott | Psychologist | 17 Executive Park Dr, Ne, Suite 510, Atlanta, GA 30329 | 2012-12-10 |
| 1669745675 | Walter Brooks | Psychologist | 159 Forsyth St Sw, Atlanta, GA 30303-3634 | 2012-02-22 |
| 1699907964 | Townes Consulting and Psychological Services, LLC | Psychologist | 191 Peachtree Street, Suite 3300, Atlanta, GA 30303-1740 | 2009-08-20 |
| 1003028044 | George H. Williams | Psychologist | 34 Lenox Pointe, Atlanta, GA 30324-3032 | 2007-05-03 |
| 1457482994 | Melanie Lynne Harris | Psychologist | Psi Mccarty Bldg, 2055 Mount Paran Rd, Nw, Atlanta, GA 30327 | 2007-03-08 |
| 1356452122 | Suzanne Paulette Baker | Psychologist | 1780 Century Blvd Ne, Suite A, Atlanta, GA 30345-3399 | 2006-08-31 |
| 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.