McIntosh Trail CSB

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MCINTOSH TRAIL CSB

Doing business as

Upson Co Counseling Center

Practice address

713 Andrews Dr
Thomaston, GA 30286-4524

Phone

(770) 358-5252

NPI assigned

Feb 13, 2008

Organization subpart

No

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

Authorized official

Name

Shari Thomas

Title

Cfo

Phone

(770) 358-8254

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Upson Co Counseling Center Doing business as

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1265600100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 N EXPRESSWAY",
            "address_2": "SUITE 301",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302239016",
            "telephone_number": "770-358-8250",
            "fax_number": "770-229-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 ANDREWS DR",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302864524",
            "telephone_number": "770-358-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCINTOSH TRAIL CSB",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SHARI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-358-8254"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000601609K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upson Co Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathy E Mansfield, MD
• Mark E. Cotney, D.C., P.C.
• Dawn C McCoy, RD
• Jerica L. McCrary, MPA
• Baleigh McDaniel
• Layne McLendon, NP-C
• Tiffany McLendon, CSFA
• David L McSwain, R.PH.
• Michael T Allen DDS, LLC
• Holly D Moore, LMFT

• Community/Behavioral Health Agency in Thomaston, GA
• Providers in Thomaston, 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 Dec 17, 2015; 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.