Kenneth M Bleicher

Individual provider Active NPI Mental Health Counselor · Fort Valley, GA

NPI 1821671868 · NPPES record last updated Apr 28, 2021

Key facts

NPI
1821671868
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
007798 (GA)
Practice address
1809 River Rd
Fort Valley, GA 31030-7029
Phone
(478) 827-3224
NPI assigned
Apr 28, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
The Peach Pit Past
since May 16, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 007798 GA Yes

Addresses

Primary practice location

1809 River Rd
Fort Valley, GA 31030-7029

Mailing address

1809 River Rd
Fort Valley, GA 31030-7029

Electronic endpoints

TypeEndpointUseAffiliation
Other URL https://thepeachpitgeorgia.org/

Other providers in Fort Valley, GA

All providers in Fort Valley, GA · Mental Health Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.