PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES LLC (NPI# 1689198194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689198194 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES LLC |
| Other Organization Name | PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES, LLC |
| Practice Address |
2824 Hillcreek Dr Augusta GA 30909-5628 |
| Mailing Address |
2824 Hill Creek Drive Augusta GA 30909-5628 |
| Mailing Telephone | 7068262770 |
| Mailing Fax Number | 7068262771 |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | DR. STEPHANIE ANNE NORTHINGTON (PSYCHOLOGIST/PARTNER) |
| Authorized Official Telephone | 7068262770 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | GA | Behavioral Health & Social Service Providers | |
| N | 106S00000X | Behavior Technician | GA | Behavioral Health & Social Service Providers | |
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | GA | Speech, Language and Hearing Service Providers | |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | SPEECH THERAPY | 1700123163 | 01 |
| GA | OCCUPATIONAL THERAPY | 1386012573 | 01 |
| GA | PSYCHOLOGY | 1457632150 | 01 |
| Other Name | Type Code |
|---|---|
| P.A.C.E.S., LLC | Doing Business As Name - Organization |
| Pediatric Autism Clinical & Evaluation Services, LLC | Doing Business As Name - Organization |
| Street Address |
2824 HILLCREEK DR |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-5628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386825222 | Audrey Henderson M.d.p.c. | Specialist | 2824 Hillcreek Dr, Augusta, GA 30909-5628 | 2007-11-20 |
| 1730747478 | Leanne Marie Row | Occupational Therapist | 2824 Hillcreek Dr, Augusta, GA 30909-5628 | 2019-05-29 |
| 1114412863 | Adam Lee Allen | Behavioral Analyst | 2824 Hillcreek Dr, Augusta, GA 30909 | 2018-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1932635885 | Samantha L. Whatson | Psychologist | 3633 Wheeler Rd Ste 110, Augusta, GA 30909-6544 | 2017-05-11 |
| 1942743679 | Medoptions of Maine, LLC | Psychologist | 45 Memorial Cir, Augusta, ME 04330-6400 | 2016-11-29 |
| 1942652656 | Nancy Slobodnik | Psychologist | 1 Va Ctr # 28, Augusta, ME 04330-6719 | 2016-07-06 |
| 1710315171 | Holly Tabernik | Psychologist | 3405 Mike Padgett Hwy Bldg 10, Augusta, GA 30906-3815 | 2013-10-23 |
| 1225383078 | Sarah Bruce Stevens | Psychologist | 44 Thornberry Drive, Augusta, GA 30909-1922 | 2012-07-18 |
| 1326277831 | Katharine Elliott Mocciola | Psychologist | 1 Va Ctr # 116b, Augusta, ME 04330-6719 | 2009-07-06 |
| 1467635441 | Dana P. Reaume | Psychologist | 74 Bristlecone Ln, Augusta, GA 30909-1847 | 2007-12-12 |
| 1548460124 | Sarah Faith Shelton | Psychologist | 1829 Wrightsboro Rd, Augusta, GA 30904-2010 | 2007-07-20 |
| 1679623086 | M. Kevin Turner | Psychologist | 103 Rossmore Pl, Augusta, GA 30909-5769 | 2007-01-11 |
| Find all providers in AUGUSTA | ||||
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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.