Greater Georgia Behavioral Health

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GREATER GEORGIA BEHAVIORAL HEALTH

Practice address

160 Carnegie PL
Fayetteville, GA 30214-3905

Phone

(470) 435-8028

NPI assigned

Oct 22, 2025

Organization subpart

No

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

Authorized official

Name

Matt Dinicola

Title

Member

Phone

(781) 472-0247

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Demetria Woodruff, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, GA
  • NPI 1679464523
  NPD (past)

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1568339554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE HWY STE 100",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020812557",
            "telephone_number": "470-435-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CARNEGIE PL",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143905",
            "telephone_number": "470-435-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER GEORGIA BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "DINICOLA",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "781-472-0247"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latoya Gray
• Sharmane Marie Gray, MD
• Charlotte Elizabeth Grayson- Mathis, M.D.
• Christa Grayson, CADC-II
• Greater Atlanta Youth Development Corporation
• Leshundra Green
• Neffera Green, RBT
• Wallace Maxwell Green, PAC
• Susanne Greenblatt, P.T.
• Greenline Health Services, Inc

• All providers in Fayetteville, GA
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.