Makala Clinch Mangram, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN300259 Issued in GA

Practice address

700 Coastal Village Dr
Brunswick, GA 31520-1974

Phone

(912) 230-3047

NPI assigned

Feb 3, 2025

Last updated

Feb 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gateway Community Service BoardGroup PAC ID 3173510237, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Gateway Community Service Board

  • Community/Behavioral Health Agency
  • Brunswick, GA
  • NPI 1558478214

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Clarity Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brunswick, GA
  • NPI 1326905944

  Single Specialty

  NPD Authorized official
• Gateway Behavioral Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Brunswick, GA
  • NPI 1124254321
  NPD

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1952115743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11014 WOODLAND TRL",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315251283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 COASTAL VILLAGE DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315201974",
            "telephone_number": "912-230-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGRAM",
        "first_name": "MAKALA",
        "middle_name": "CLINCH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN300259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdalene Inc
• Magnolia Grace Senior Care of Georgia, LLC
• Carolanne Majeski, APRN
• Muhammad Ahmad Malik, M.D.
• Kathleen Byington Malone, D.O.
• Elizabeth Romanowski Mann, OTD, OTR/L
• Michelle Denise Mann, PAA
• David M Manning Jr.
• Steven A Mansfield, LPC
• Muzafar Mansoor, M.D

• Psychiatric/Mental Health Nurse Practitioner in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.