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Organization

MCG EAP SERVICES, INC.

Active
Other names
Southern Behavioral Services
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MIONA G GORDON (PRESIDENT)
(478) 742-1464
Entity
Organization

Contact information

Practice address
179 PIERCE AVE, MACON, GA 31204-2821
(478) 742-1464
(478) 742-1883
Mailing address
179 PIERCE AVE, MACON, GA 31204-2821
(478) 742-1464
(478) 742-1883

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
004182
GA
106H00000X
Marriage & Family Therapist
000992
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
116537069A
GA
Enumeration date
05/19/2006
Last updated
08/26/2008
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