TIFTON ADDICTION ASSOCIATES, LLC. D/B/A TLC CLINIC (NPI# 1821393380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821393380 |
Entity Type | Organization |
Organization Name | TIFTON ADDICTION ASSOCIATES, LLC. D/B/A TLC CLINIC |
Practice Address |
2402 North Tift Ave Suite 202 Tifton GA 31794 |
Mailing Address |
2402 Tift Ave N Ste 202 Tifton GA 31794-1885 |
Practice Telephone | 2293827898 |
Mailing Telephone | 2293827898 |
Enumeration Date | 2011-01-14 |
Last Update Date | 2011-01-14 |
Authorized Official Name | JONATHAN PAUL CONNELL (MANAGING MEMBER) |
Authorized Official Telephone | 2293827898 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
NTP001047 | GA | Allopathic & Osteopathic Physicians |
N | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
PHOP000045 | GA | Pharmacy Service Providers |
N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
NTP001047 | GA | Allopathic & Osteopathic Physicians |
Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
NTP001047 | GA | Allopathic & Osteopathic Physicians |
Street Address |
2402 NORTH TIFT AVE SUITE 202 |
City | TIFTON |
State | GA |
Zip Code | 31794 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
Find all providers in zip 31794 |
Taxonomy Code | 2084A0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Addiction Medicine |
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
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1093338816 | Summit Wellness Group With Flaire Inc | Psychiatry & Neurology | 996 Huff Rd Nw Ste C, Atlanta, GA 30318-4333 | 2020-05-27 |
1578183737 | Veda Lara LLC | Psychiatry & Neurology | 1530 Laurel Park Cir Ne, Atlanta, GA 30329-3217 | 2020-04-17 |
1023651312 | Atlantic Advanced Branded Center, LLC. | Psychiatry & Neurology | 3635 Peachtree Industrial Blvd Ste 550, Duluth, GA 30096-2806 | 2019-10-20 |
1003211467 | Advanced Neuropsychiatric Health Professionals LLC | Psychiatry & Neurology | 2150 Peachford Rd Ste 1, Atlanta, GA 30338-6520 | 2014-10-28 |
1124331970 | Albany Addiction Associates, Inc. D/b/a Private Clinic Albany | Psychiatry & Neurology | 2607 Ledo Rd, Albany, GA 31707-1211 | 2010-07-22 |
1780811166 | Charles L Whitfield | Psychiatry & Neurology | 3462 Hallcrest Dr Ne, Atlanta, GA 30319-1910 | 2009-06-12 |
1003863788 | Family Behavioral Care of Central Ga, PC | Psychiatry & Neurology | 3985 Arkwright Rd, Suite 102, Macon, GA 31210-1774 | 2006-05-28 |
1396277968 | Psychiatric Professionals of Georgia | Psychiatry & Neurology | 1490 Distribution Dr Ste 150, Suwanee, GA 30024-2847 | 2017-04-01 |
1477097012 | Hope Springs Wellness and Recovery | Psychiatry & Neurology | 800 Kennesaw Ave Nw, Suite 120, Marietta, GA 30060-1051 | 2016-12-16 |
1427484492 | Db Chandora Mdpc | Psychiatry & Neurology | 362 Upper Riverdale Rd Sw, Riverdale, GA 30274-2560 | 2013-09-22 |
Find all providers with the same taxonomy |
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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.