CLAYTON MHDDAD NPI 1992984264

NPI Information

NPI: 1992984264
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:
217 STOCKBRIDGE RD
JONESBORO, GA
ZIP 30236
Phone: (770) 471-4617
Get Directions

CLAYTON MHDDAD is a mental health (including community mental health center) clinic center in Jonesboro, GA. CLAYTON MHDDAD NPI is 1992984264. The provider is registered as an organization entity type.
The provider Is Doing Business As Clayton Csb.

The provider's business location address is:

217 STOCKBRIDGE RD
JONESBORO, GA
ZIP 30236-628
Phone: (770) 471-4617
Fax: (770) 471-7817

The provider's authorized official is Jade Benefield .
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 11/2/2007 and was last updated on 6/10/2008.

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	Primary
1	251S00000X	Community/Behavioral Health		No
2	251C00000X	Day Training, Developmentally Disabled Services		No
3	261QA0600X	Clinic/Center	Adult Day Care	No
4	261QM0850X	Clinic/Center	Adult Mental Health	No
5	261Q00000X	Clinic/Center		No
6	261QC1500X	Clinic/Center	Community Health	No
7	261QD1600X	Clinic/Center	Developmental Disabilities	No
8	101YM0800X	Counselor	Mental Health	No
9	103T00000X	Psychologist		No
10	104100000X	Social Worker		No
11	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
1	26BDJGQ	MEDICARE PIN	GEORGIA
2	00607076D	MEDICAID	GEORGIA
3	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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »