Provider Demographics
NPI:1326289059
Name:BETTER MOOD CLINIC
Entity Type:Organization
Organization Name:BETTER MOOD CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WEINGARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:229-333-2273
Mailing Address - Street 1:PO BOX 2516
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-2516
Mailing Address - Country:US
Mailing Address - Phone:229-333-2273
Mailing Address - Fax:229-293-7911
Practice Address - Street 1:2935 N ASHLEY ST
Practice Address - Street 2:BLDG. F
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1777
Practice Address - Country:US
Practice Address - Phone:229-333-2273
Practice Address - Fax:229-293-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0036851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1144204678OtherNPI NUMBER