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THE PEACH PIT NPI 1023511789


NPI Information

NPI: 1023511789
Provider Name: THE PEACH PIT
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
1809 RIVER RD
FORT VALLEY, GA
ZIP 31030
Phone: (478) 827-3224
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THE PEACH PIT is a clinical social worker in Fort Valley, GA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. THE PEACH PIT NPI is 1023511789. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1809 RIVER RD
FORT VALLEY, GA
ZIP 31030-029
Phone: (478) 827-3224

The provider's authorized official is Gwendolyn Coley .
The authorized official title is Clinical Director and has the following contact phone number (478) 827-3224.

The enumeration date for this NPI number is 3/8/2018 and was last updated on 3/29/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalNo
2104100000XSocial WorkerNo
3171M00000XCase Manager/Care CoordinatorNo
4174400000XSpecialistNo
5251V00000XVoluntary or CharitableNo
61041C0700XSocial WorkerClinicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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