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Gateway Behavioral Health Services

Organization Active NPI Psychologist · Woodbine, GA

NPI 1992834550 · NPPES record last updated Oct 20, 2011

Key facts

NPI
1992834550
Entity type
Organization (NPI type 2)
Primary specialty
Psychologist 103T00000X
Legal business name
GATEWAY BEHAVIORAL HEALTH SERVICES
Practice address
210 E 15TH St
Woodbine, GA 31569-5501
Phone
(912) 576-5075
Fax
(912) 576-3543
NPI assigned
Mar 2, 2007
Organization subpart
No

Authorized official

Name
Dr. William Parks
Title
Cfo
Phone
(912) 554-8464

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Gateway Community Service Board (72 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist
Group: 193400000X SINGLE SPECIALTY GROUP		 103T00000X Yes

Addresses

Primary practice location

210 E 15TH St
Woodbine, GA 31569-5501

Mailing address

700 Coastal Village Dr
Brunswick, GA 31520-1974
Phone (912) 554-8510

Other identifiers

IdentifierTypeStateIssuer
000622553CMedicaidGA

Other names

  • Gateway BHS - TC Now Other name

Other providers in Woodbine, GA

All providers in Woodbine, GA · Psychologist in Georgia

Sources for this page

Verify at the official NPI Registry.