CLAYTON MHDDAD NPI 1306034012

NPI Information

NPI: 1306034012
Provider Name: CLAYTON MHDDAD

Doing Business As: CLAYTON CSB

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
8132 KENDRICK RD
B&C
JONESBORO, GA
ZIP 30238
Phone: (770) 471-5249
Get Directions

CLAYTON MHDDAD is a mental health (including community mental health center) clinic center in Jonesboro, GA. CLAYTON MHDDAD NPI is 1306034012. The provider is registered as an organization entity type.
The provider Is Doing Business As Clayton Csb.

The provider's business location address is:

8132 KENDRICK RD
B&C
JONESBORO, GA
ZIP 30238-933
Phone: (770) 471-5249
Fax: (770) 477-9772

The provider's authorized official is Terry Cole .
The authorized official title is Executive Director and has the following contact phone number (770) 478-2280.

The enumeration date for this NPI number is 10/9/2007 and was last updated on 11/8/2011.

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
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00604205Q	MEDICAID	GEORGIA
2	GRP2322	MEDICARE PIN	GEORGIA

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

NPI Synchronization or Removal

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