Csra Psychological Services Limited Liability Company

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CSRA PSYCHOLOGICAL SERVICES LIMITED LIABILITY COMPANY

Practice address

930 Glenhaven Dr
Evans, GA 30809-0445

Phone

(706) 814-6429

Fax

(706) 814-6429

NPI assigned

Sep 18, 2023

Last updated

Sep 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth L Edwards, LPCNPI 1114384054

Title

Owner

Phone

(706) 814-6429

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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.

• Elizabeth Lynn Edwards, LPC

  • Professional Counselor
  • Evans, GA
  • NPI 1114384054
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1811775216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COMMERCIAL BLVD PO BOX 204301",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309174301",
            "telephone_number": "706-814-6429",
            "fax_number": "706-814-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 GLENHAVEN DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308090445",
            "telephone_number": "706-814-6429",
            "fax_number": "706-814-6429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 Courthouse Ln",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012447",
            "country_code": "US",
            "telephone_number": "706-814-6429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CSRA PSYCHOLOGICAL SERVICES LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-814-6429",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Daves Croley, RPH
• Joseph Michael Crosby, PHYSICIAN ASSISTANT
• Mariyah Renee Cross, LAPC
• Darrell Lamar Cruce, LPN
• Csra Anesthesia
• Leila Cullars, RN, BSN
• De'Ja Nicole Culpepper, RBT
• Brian Mitchell Cunningham, D.O.
• Brittany Cunningham
• Ashton Renee Curry, PT, DPT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Evans, GA
• Providers in Evans, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.