Pure Heart Behavioral Therapy, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PURE HEART BEHAVIORAL THERAPY, LLC

Practice address

359 Shady Dale Rd
Eatonton, GA 31024

Phone

(478) 569-6235

Fax

(478) 238-8920

NPI assigned

Mar 5, 2020

Last updated

May 9, 2023By 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

Mrs. Samantha Weldon, MAT, BCBANPI 1609300839

Title

Owner

Phone

(478) 569-6235

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Samantha Weldon

  • Behavior Analyst
  • Milledgeville, GA
  • NPI 1609300839
  NPD (past) Authorized official
• Claire Greenway

  • Behavior Analyst
  • Milledgeville, GA
  • NPI 1538650379
  NPD (past)

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1396370862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 702",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "31059",
            "telephone_number": "478-569-6235",
            "fax_number": "478-238-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 SHADY DALE RD",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "31024",
            "telephone_number": "478-569-6235",
            "fax_number": "478-238-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE HEART BEHAVIORAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-05",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "WELDON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-569-6235",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MAT, BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Eatonton, GA
• Providers in Eatonton, 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 May 9, 2023; 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.