Catoosa Behavior Health and Wellness Clinic LLC
Organization Active NPI Family Medicine Physician · Ringgold, GA
NPI 1073471876 · NPPES record last updated Apr 28, 2026
Key facts
- NPI
- 1073471876
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CATOOSA BEHAVIOR HEALTH AND WELLNESS CLINIC LLC
- Practice address
- 102 RBC Dr
Ringgold, GA 30736-2787 - Phone
- (404) 937-0561
- Fax
- (404) 937-0561
- NPI assigned
- Jan 12, 2026
- Organization subpart
- No
Authorized official
- Name
- Lud Harris, PMHNP
- Title
- Clinical Director
- Phone
- (404) 937-0561
Practitioners 2
-
Douglas Ray White, M.D.
-
Lud Denose-Harris, PMHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260516000328 | GA | Part B Supplier - Clinic/Group Practice | 2062981228 |
Receives reassigned benefits from 1 practitioner Practice locations: Ringgold, GA |
National Provider Directory
Locations
102 Rbc Dr
Ringgold, GA 30736
Phone (423) 827-4705
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Community Health Clinic/Center | 261QC1500X |
Addresses
Primary practice location
102 RBC Dr
Ringgold, GA 30736-2787
Mailing address
102 RBC Dr
Ringgold, GA 30736-2787
Phone (404) 937-0561
Other providers in Ringgold, GA
- Monica Lynn Burruss Carney
- Amy Carroll
- Chloe Carson
- Jacqueline Casey
- Venessa Gay Cates
- Catoosa County Board of Heatlh
- Catoosa County Public Schools
- Catoosa Family Medicine
- Holly Chandler
- Sara Jean Chaney
All providers in Ringgold, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.