GEORGIA BEHAVIORAL HEALTH PRACTITIONER CLINIC
NPI 1699239475
Clinic/Center - Mental Health (Including Community Mental Health Center) in Tucker, GA
NPI Status: Active since January 26, 2019
Contact Information
2206 HANFRED LN STE 103
TUCKER, GA
ZIP 30084
Phone: (678) 831-6429
Fax: (687) 668-2848
- Organization
- Clinic/Center
- Mental Health (Including Community Menta...
- CLIA Number: 11D2161626
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 02-06-2027
About GEORGIA BEHAVIORAL HEALTH PRACTITIONER CLINIC
This page provides the complete NPI Profile along with additional information for Georgia Behavioral Health Practitioner Clinic, a provider established in Tucker, Georgia operating as a Clinic/center, focusing in mental health (including community mental health center) . The healthcare provider is registered in the NPI registry with number 1699239475 assigned on January 2019. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Georgia Behavioral Health Practitioner Clinic. The authorized official of this NPI record is Louise Wise (Provider)
- NPI
- 1699239475
- Provider Legal Name
- LOUISE WISE LLC
- Other Organization Name
- GEORGIA BEHAVIORAL HEALTH PRACTITIONER CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2206 HANFRED LN STE 103 TUCKER, GA 30084
- Location Phone
- (678) 831-6429
- Location Fax
- (687) 668-2848
- Mailing Address
- PO BOX 309 CLARKSTON, GA 30021
- Mailing Phone
- (678) 368-5561
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-26-2019
- Last Update Date
- 04-09-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Mental Health (Including Community Mental Health Center)
- Taxonomy Code
- 261QM0801X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2161626
- Facility Type
- Practitioner Other
- Certificate Effective Date
- February 07, 2025
- Certificate Expiration Date
- February 06, 2027
- Laboratory Director
- LOUISE WISE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Georgia Behavioral Health Practitioner Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 9 | 9 | 2 | 3 | 9 | 4 | 7 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 18 | 9 | 4 | 3 | 18 | 4 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 8 + 9 + 4 + 3 + 1 + 8 + 4 + 1 + 4 + 24 = 75 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 75 = 5 | 5 | ||||||||
The NPI number 1699239475 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1851782965 | LOUISE WISE DNP, PMHNP-BC Individual | Nurse Practitioner (Psychiatric/Mental Health) | 2206 HANFRED LN STE 103 TUCKER, GA 30084 (678) 831-6429 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699239475, enumerated in the NPI registry as an "organization" on January 26, 2019
The provider is located at 2206 Hanfred Ln Ste 103 Tucker, Ga 30084 and the phone number is (678) 831-6429
This medical organization specializes in Clinic/Center with taxonomy code 261QM0801X with a focus in Mental Health (Including Community Mental Health Center)
The provider's CLIA number is 11D2161626 for a "practitioner other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on January 26, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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