Southeastern Psychiatric Management, Inc
Organization Active NPI Mental Health Counselor · Ft Payne, AL
NPI 1154485647 · NPPES record last updated Mar 12, 2008
Key facts
- NPI
- 1154485647
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Legal business name
- SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC
- Practice address
- 701 Gault Avenue
Ste B
Ft Payne, AL 35967-2627 - Phone
- (256) 845-8227
- Fax
- (256) 845-8226
- NPI assigned
- Dec 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Joy R Ballenger
- Title
- Credentialing Network Manager
- Phone
- (256) 546-9265
Other NPIs on the same Medicare enrollment 5
Practitioners 7
-
Richard Edward Grant, M.D.
-
Jim Parker, LCSW
-
George Michael Shehi, M.D.
-
Daphne Simpson, ALC
-
Lisa Miya Jones, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050420000219 | AL | Part B Supplier - Clinic/Group Practice | 5799743928 |
Receives reassigned benefits from 8 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Gadsden, AL |
National Provider Directory
Locations
701 Gault Ave N
Ste B
Fort Payne, AL 35967
Phone (256) 546-9265
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | Yes |
Addresses
Primary practice location
701 Gault Avenue
Ste B
Ft Payne, AL 35967-2627
Mailing address
3001 Scenic Hwy
Gadsden, AL 35904-3047
Phone (256) 546-9265
Other names
- GrandView Behavioral Health Center
Other providers in Ft Payne, AL
- Aimee S Skelton
- Mark Skelton
- Lindsay E Slater
- Vernie Slaton
- Southeast Cancer Network, Inc
- State of Alabama
- State of Alabama Department of Public Health
- State of Alabama Department of Public Health
- State of Alabama Department of Public Health
- State of Alabama Department of Public Health
All providers in Ft Payne, AL · Mental Health Counselor in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2008. 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.