Thomasville Family Counseling Center

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY002460 Issued in GA

Legal business name

THOMASVILLE FAMILY COUNSELING CENTER

Practice address

330 N Broad St Ste B
Thomasville, GA 31792-5100

Phone

(229) 551-9300

Fax

(229) 226-4649

NPI assigned

May 5, 2008

Organization subpart

No

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

Authorized official

Name

Cindy J Brengosz

Title

Office Manager

Phone

(229) 551-9300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Christine M. Renaud Other name

Practitioners 1

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

• Christine M Renaud, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Thomasville, GA
  • NPI 1629174032
  NPD (past)

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1699941187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1353",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317991353",
            "telephone_number": "229-551-9300",
            "fax_number": "229-226-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N BROAD ST STE B",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925100",
            "telephone_number": "229-551-9300",
            "fax_number": "229-226-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMASVILLE FAMILY COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "BRENGOSZ",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE  MANAGER",
        "authorized_official_telephone_number": "229-551-9300"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY002460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000784209B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christine M. Renaud",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Thomasville Care Center LLC
• Thomasville Dental Center
• Thomasville Dental Center
• Thomasville Eye Care PC
• Thomasville Eye Care, LLC
• Thomasville Family Medicine Center, LLC
• Thomasville Foot and Ankle Center
• Thomasville I Enterprises, LLC
• Thomasville Obstetrics and Gynecology, P.C.
• Thomasville Operating Company LLC

• Clinical Child & Adolescent Psychologist in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Clinical Child & Adolescent Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.