JAMES PENDERGRASS (NPI# 1588072995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588072995 |
| Entity Type | Individual |
| Full Name | JAMES PENDERGRASS |
| Credential | LMFT |
| Practice Address |
144 Pierce Ave Macon GA 31204-2860 |
| Practice Telephone | 4789555468 |
| Mailing Telephone | 4789555468 |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFT001341 | GA | Behavioral Health & Social Service Providers |
| Street Address |
144 PIERCE AVE |
| City | MACON |
| State | GA |
| Zip Code | 31204-2860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639248982 | Daniel H Johnston | Psychologist | 144 Pierce Ave, Macon, GA 31204-2860 | 2006-11-08 |
| 1467912493 | Kristy Jay Wilson | Marriage & Family Therapist | 144 Pierce Ave, Macon, GA 31204-2860 | 2019-03-25 |
| 1013471028 | Quitman John Brigmond Jr. | Counselor | 144 Pierce Ave, Macon, GA 31204-2860 | 2019-01-23 |
| 1437505021 | Jacquelin Wilson | Counselor | 144 Pierce Ave, Macon, GA 31204-2860 | 2016-05-12 |
| 1306202882 | Dorothy Wynens Rehberg | Counselor | 144 Pierce Ave, Macon, GA 31204-2860 | 2016-01-13 |
| 1568730216 | Bryan Mcmullen | Marriage & Family Therapist | 144 Pierce Ave, Macon, GA 31204-2860 | 2011-12-09 |
| 1164646386 | Scott Pendleton Serafy | Counselor | 144 Pierce Ave, Macon, GA 31204-2860 | 2007-04-11 |
| 1265584221 | Terrence G Mermann | Counselor | 144 Pierce Ave, Macon, GA 31204-2860 | 2007-01-18 |
| 1558433888 | Gaye Brown Ethridge | Social Worker | 144 Pierce Ave, Crossroads Counseling Center, Macon, GA 31204-2860 | 2006-11-14 |
| 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 | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902448681 | Alicia Roberts | Marriage & Family Therapist | 2607 Vineville Ave Ste 101, Macon, GA 31204-0900 | 2019-10-14 |
| 1184271561 | Kathlyn Wohlrabe | Marriage & Family Therapist | 3780 Bloomfield Village Dr Ste 1, Macon, GA 31206-0806 | 2019-08-21 |
| 1710487269 | Blue Cedar Counseling | Marriage & Family Therapist | 3263 Vineville Ave, Macon, GA 31204-2343 | 2018-02-20 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1316222946 | Gerri A Robbins | Marriage & Family Therapist | 577 Mulberry St, Suite 1000, Macon, GA 31201-2728 | 2011-10-14 |
| 1699099572 | Martha Harrell Fennell | Marriage & Family Therapist | 265 Orange St, Macon, GA 31201-1646 | 2010-03-21 |
| 1104061548 | Mary Elizabeth Key | Marriage & Family Therapist | 577 Mulberry St Ste 1000, Macon, GA 31201-8225 | 2008-12-15 |
| 1275778631 | Gerald P Allums | Marriage & Family Therapist | 277 Martin Luther King Jr Blvd Ste 203, Macon, GA 31201-3498 | 2008-12-12 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1659589356 | Cesar A Dumelod | Marriage & Family Therapist | 310 Ashville Ct, Macon, GA 31210-1669 | 2007-05-18 |
| 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.