NPIMap

Organization Active NPI

CSB of Middle Georgia

Doing business as Community Mental Health Center of Middle GA

  • Adult Mental Health Clinic/Center
  • Dublin, GA
National Provider Identifier
1508169400
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
RN126651 Issued in GA
Legal business name
CSB OF MIDDLE GEORGIA
Doing business as
Community Mental Health Center of Middle GA
Practice address
2121-A Bellevue Rd
Dublin, GA 31021-2998
Phone
(478) 272-1190
Fax
(478) 275-6649
NPI assigned
Dec 15, 2010
Last updated
Dec 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Authorized official

Name
Ms. Patsy H Thomas, ED.D.
Title
Executive Director
Phone
(478) 272-1190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X RN126651 GA Primary

Addresses

Primary practice location

2121-A Bellevue Rd
Dublin, GA 31021-2998

Mailing address

2121A Bellevue Rd
Dublin, GA 31021-2998
Phone (478) 272-1190

Other identifiers 1

IdentifierTypeStateIssuer
000606284HMedicaidGA

Other names 1

  • Community Mental Health Center of Middle GA Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0950830Community Mental Health Center2121-A Bellevue Rd, Dublin, GA 31021Certificate of waiverSep 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
Community Service Board of Middle Georgia30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1508169400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121A BELLEVUE RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212998",
            "telephone_number": "478-272-1190",
            "fax_number": "478-275-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121-A BELLEVUE RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212998",
            "telephone_number": "478-272-1190",
            "fax_number": "478-275-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSB OF MIDDLE GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "PATSY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "478-272-1190",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "GA",
            "license": "RN126651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606284H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Mental Health Center of Middle GA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.