Maribill Behavioral Health Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

10018261 Issued in GA

Legal business name

MARIBILL BEHAVIORAL HEALTH SERVICES, LLC

Practice address

2385 Wall St SE
Conyers, GA 30013-2187

Phone

(770) 891-2170

NPI assigned

Mar 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. William Thomas, PH.D., ICADC

Title

Ceo/President

Phone

(770) 891-2170

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1740503242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 WALL ST SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132187",
            "telephone_number": "770-891-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 WALL ST SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132187",
            "telephone_number": "770-891-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIBILL BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "770-891-2170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., ICADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "10018261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Erin Manley, PAC
• Michael Joseph Manning, M.D.
• Kelly Marchman, RBT
• Margaret Gibson Ellison, LPC LLC
• Lisa Ann Maria, RCP
• Mark Shurett DDS PC
• Mark Shurett DDS PC
• Alexis Savannah Marks, APRN, FNP-BC
• Yashanti K Marks, M.S., CCC-SLP
• Avantai Laureem Marlin, RBT

• Community/Behavioral Health Agency in Conyers, GA
• Providers in Conyers, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.