Provider Demographics
NPI:1306010954
Name:THE EUPATHEIA CENTER INC
Entity Type:Organization
Organization Name:THE EUPATHEIA CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:ENGEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:912-816-0076
Mailing Address - Street 1:664 SCRANTON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-1947
Mailing Address - Country:US
Mailing Address - Phone:912-285-1610
Mailing Address - Fax:912-285-2595
Practice Address - Street 1:664 SCRANTON RD STE 201
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-1947
Practice Address - Country:US
Practice Address - Phone:912-285-1610
Practice Address - Fax:912-285-2595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10032838OtherAMERIGROUP
GA524588165AMedicaid
GA000577585GMedicaid
GA085726452AMedicaid