NPIMap

Organization Active NPI

McIntosh Trail CSB

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Griffin, GA
National Provider Identifier
1649495268
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
000427 Issued in GA
Legal business name
MCINTOSH TRAIL CSB
Practice address
136 N Hill St
Griffin, GA 30223-3335
Phone
(770) 358-8470
NPI assigned
Apr 17, 2007
Last updated
Jul 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Ms. Linda P. Robinson, LCSW, MAC, CCSNPI 1962624965
Title
Addictive Disease Coordinator
Phone
(770) 358-8470

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 000427 GA Primary

Addresses

Primary practice location

136 N Hill St
Griffin, GA 30223-3335

Mailing address

1436 Catherine St
Decatur, GA 30030-4505
Phone (404) 377-0541

Other identifiers 2

IdentifierTypeStateIssuer
000427OtherGALIC.CLINICALSOCIALWORKER
1000OtherGACERTIFIEDADDICTIONCOUN II

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1649495268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 CATHERINE ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304505",
            "telephone_number": "404-377-0541",
            "fax_number": "404-687-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N HILL ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302233335",
            "telephone_number": "770-358-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCINTOSH TRAIL CSB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "ADDICTIVE DISEASE COORDINATOR",
        "authorized_official_telephone_number": "770-358-8470",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, MAC, CCS"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "GA",
            "license": "000427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC.CLINICALSOCIALWORKER",
            "identifier": "000427",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIEDADDICTIONCOUN II",
            "identifier": "1000",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 7, 2008; 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.