Clayton Community Service Board

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

APC002869 Issued in GA

Legal business name

CLAYTON COMMUNITY SERVICE BOARD

Practice address

853 Battlecreek Rd
Jonesboro, GA 30236-1919

Phone

(770) 478-1099

Fax

(770) 603-4797

NPI assigned

Jun 12, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Dorothy A. Fortuchang, MS, LAPC, NCC

Title

Substance Abuse Counselor

Phone

(770) 478-1099

Specialties & licenses 1

Addresses

Other names 1

• Clayton Center Behavioral Health Other name

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1881956183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 BATTLECREEK RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361919",
            "telephone_number": "770-478-1099",
            "fax_number": "770-603-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 BATTLECREEK RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361919",
            "telephone_number": "770-478-1099",
            "fax_number": "770-603-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON COMMUNITY SERVICE BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "FORTUCHANG",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SUBSTANCE ABUSE COUNSELOR",
        "authorized_official_telephone_number": "770-478-1099",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, LAPC, NCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "APC002869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clayton Center Behavioral Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Clayton Center CSB
• Clayton Chiropractic Center
• Clayton Community Mental Health Substance Ab (Clayton CSB)
• Clayton Community Mental Health Substance Ab (Clayton CSB)
• Clayton Community Mental Health Substance Abuse Deve SVCS Board (Clayton Center CSB)
• Clayton County Board of Commissioners
• Clayton County Health District
• Clayton County Public Schools Dba Worktec
• Clayton Healthcare, P.C.
• Clayton Medical Surgical (Clayton Minor Emergency Center)

• Community/Behavioral Health Agency in Jonesboro, GA
• Providers in Jonesboro, 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 Jun 12, 2012; 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.