Organization
CLAYTON COMMUNITY MENTAL HEALTH SUBSTANCE AB
Active
Parent organization
CLAYTON COMMUNITY MENTAL HEALTH SUBSTANCE ABUSE DEVE SVCS
Other names
Clayton CSB
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLAYTON COMMUNITY MENTAL HEALTH SUBSTANCE ABUSE DEVE SVCS
Authorized official
TERRY COLE (EXECUTIVE D IRECTOR)
(770) 478-2280
Entity
Organization
Contact information
Practice address
853 BATTLECREEK RD, JONESBORO, GA 30236-1919
(770) 478-2280
(770) 477-9772
Mailing address
157 SMITH ST, JONESBORO, GA 30236-3546
(770) 478-2280
(770) 477-9772
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
104100000X
Social Worker
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00604205E
—
GA
01
—
GRP2322
CAHABA GBA
GA
Enumeration date
12/29/2005
Last updated
11/15/2011
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