Provider Demographics
NPI:1043439722
Name:SOUTHEASTERN BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:SOUTHEASTERN BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRESHAM MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, ACSW, MAC
Authorized Official - Phone:706-364-8683
Mailing Address - Street 1:1723 MILL ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-4083
Mailing Address - Country:US
Mailing Address - Phone:706-364-8683
Mailing Address - Fax:706-364-8683
Practice Address - Street 1:1723 MILL ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-4083
Practice Address - Country:US
Practice Address - Phone:706-364-8683
Practice Address - Fax:706-364-8683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0024571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty