NPIMap

Organization Active NPI

McIntosh Trail Community Service Board

Doing business as Behavioral Health Center

  • Community/Behavioral Health Agency
  • Griffin, GA
National Provider Identifier
1295903862
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MCINTOSH TRAIL COMMUNITY SERVICE BOARD
Doing business as
Behavioral Health Center
Practice address
1459 Williamson Rd
Griffin, GA 30224
Phone
(770) 358-5252
Fax
(770) 229-3223
NPI assigned
Feb 15, 2008
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Kenyatta Denise Walker, LCSW
Title
Ceo
Phone
(770) 358-5252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1459 Williamson Rd
Griffin, GA 30224

Mailing address

1435 North Expressway Suite 301
Griffin, GA 30223-9016
Phone (770) 358-5252

Other identifiers 1

IdentifierTypeStateIssuer
000601609NMedicaidGA

Other names 1

  • Behavioral Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040601001239 GA Part B Supplier - Clinic/Group Practice 6204818669 Receives reassigned benefits from 49 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fayetteville, GA; Griffin, GA; Jackson, GA; McDonough, GA; Thomaston, GA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1574 Williamson Rd
Griffin, GA 30224
Phone (770) 358-8247

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1295903862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 NORTH EXPRESSWAY SUITE 301",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302239016",
            "telephone_number": "770-358-5252",
            "fax_number": "770-229-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 WILLIAMSON RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "30224",
            "telephone_number": "770-358-5252",
            "fax_number": "770-229-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCINTOSH TRAIL COMMUNITY SERVICE BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENYATTA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-358-5252",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000601609N",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.