Professional Associates Health Care of Georgia

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

932102913 Issued in GA

Legal business name

PROFESSIONAL ASSOCIATES HEALTH CARE OF GEORGIA

Practice address

310 Ivanhoe Dr
Fayetteville, GA 30215-2041

Phone

(770) 461-9228

Fax

(770) 461-9228

NPI assigned

Nov 2, 2010

Last updated

Mar 14, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Agneau Jean-Simon

Title

Staff

Phone

(770) 865-5073

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Malochee Joseph, LPC, CADC

  • Professional Counselor
  • Stockbridge, GA
  • NPI 1558676023
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1225338577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S 9TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 IVANHOE DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152041",
            "telephone_number": "770-461-9228",
            "fax_number": "770-461-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ASSOCIATES HEALTH CARE OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "JEAN-SIMON",
        "authorized_official_first_name": "AGNEAU",
        "authorized_official_title_or_position": "STAFF",
        "authorized_official_telephone_number": "770-865-5073"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "932102913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priority Hospice LLC (Pathlight Hospice)
• Privia Medical Group of Georgia LLC
• Privia Pediatric Medical Group of Georgia LLC
• Procare Network
• Production Physicos,LLC
• Professional Health Access LLC
• Professional Nursing Associates of Georgia LLC
• Progressive Anesthesia LLC
• Prolevel Recovery LLC
• Provider Resource Solutions LLC

• Community/Behavioral Health Agency in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.