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Contact Information

GATEWAY BEHAVIORAL HEALTH SERVICES
210 EAST 15TH STREET
WOODBINE, GA31569
 Phone: 912-576-5075
 Fax: 912-576-3543
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for GATEWAY BEHAVIORAL HEALTH SERVICES · (Female)

NPI Number 1063545762
Status Active
Credentials
Entity Individual
Enumeration date 03/13/2007
Last updated 10/19/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA Medicaid 000622553AT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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