Resilience Mental Health,LLC
Organization Active NPI Psychiatry Physician · Eton, GA
NPI 1154104875 · NPPES record last updated Sep 5, 2023
Key facts
- NPI
- 1154104875
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- RESILIENCE MENTAL HEALTH,LLC
- Practice address
- 79 Highway 286
Unit B
Eton, GA 30705 - Phone
- (706) 971-3757
- NPI assigned
- Aug 16, 2023
- Organization subpart
- No
Authorized official
- Name
- Mrs. Teresa Rohn
- Title
- Credentialing Specialist
- Phone
- (706) 280-5830
Practitioners 4
-
Melissa Boyd, MSN, APRN, PMHNP-BC
-
John William Beckner Jr., M.D.
-
Wendie Malkinski, NURSE PRACTITIONER
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230920003554 | GA | Part B Supplier - Clinic/Group Practice | 7810341153 |
Receives reassigned benefits from 4 practitioners Practice locations: Eton, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
79 Highway 286
Unit B
Eton, GA 30705
Mailing address
79 Highway 286
Unit B
Eton, GA 30705
Phone (706) 971-3757
Other providers in Eton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2023. 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.