NPIMap

Organization Active NPI

MCG Eap Services, Inc.

  • Professional Counselor
  • Macon, GA
National Provider Identifier
1700839735
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
004182 Issued in GA
Legal business name
MCG EAP SERVICES, INC.
Practice address
179 Pierce Ave
Macon, GA 31204-2821
Phone
(478) 742-1464
Fax
(478) 742-1883
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Authorized official

Name
Ms. Miona G Gordon
Title
President
Phone
(478) 742-1464

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 004182 GA Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 000992 GA

Addresses

Primary practice location

179 Pierce Ave
Macon, GA 31204-2821

Mailing address

179 Pierce Ave
Macon, GA 31204-2821
Phone (478) 742-1464

Other identifiers 1

IdentifierTypeStateIssuer
116537069AMedicaidGA

Other names 1

  • Southern Behavioral Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170130001100 GA Part B Supplier - Clinic/Group Practice 0749562619 Receives reassigned benefits from 9 practitioners
Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Locations

179 Pierce Ave
Macon, GA 31204
Phone (478) 742-1464

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1700839735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 PIERCE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042821",
            "telephone_number": "478-742-1464",
            "fax_number": "478-742-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 PIERCE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042821",
            "telephone_number": "478-742-1464",
            "fax_number": "478-742-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCG EAP SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MIONA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-742-1464",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "004182",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "000992",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116537069A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Behavioral Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.