NPIMap

Organization Active NPI

Ese Mental Health LLC

  • Clinical Psychologist
  • Ray City, GA
National Provider Identifier
1659094704
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ESE MENTAL HEALTH LLC
Practice address
1539 Old Valdosta Rd
Ray City, GA 31645-7132
Phone
(706) 480-4322
NPI assigned
Sep 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Wendy Pearson, NPNPI 1487808754
Title
Owner
Phone
(229) 356-1360

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X

Addresses

Primary practice location

1539 Old Valdosta Rd
Ray City, GA 31645-7132

Mailing address

1539 Old Valdosta Rd
Ray City, GA 31645-7132
Phone (877) 755-2212

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1659094704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 OLD VALDOSTA RD",
            "city": "RAY CITY",
            "state": "GA",
            "postal_code": "316457132",
            "telephone_number": "877-755-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 OLD VALDOSTA RD",
            "city": "RAY CITY",
            "state": "GA",
            "postal_code": "316457132",
            "telephone_number": "706-480-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESE MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-23",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-356-1360",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ray City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.