Jenna M McCully, BACHELORS
Individual provider Active NPI Community/Behavioral Health Agency · Auburn, GA
NPI 1366907768 · NPPES record last updated Feb 10, 2019
Key facts
- NPI
- 1366907768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Practice address
- 21 Appalachee Church Rd
Auburn, GA 30011-3620 - Phone
- (678) 863-2237
- NPI assigned
- Feb 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | GA | Yes |
Addresses
Primary practice location
21 Appalachee Church Rd
Auburn, GA 30011-3620
Mailing address
120 E Trinity PL
Decatur, GA 30030-3302
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All providers in Auburn, GA · Community/Behavioral Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.