Provider Demographics
NPI:1376304402
Name:A NEW YOU PSYCHIATRIC CARE LLC
Entity Type:Organization
Organization Name:A NEW YOU PSYCHIATRIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:SHEA
Authorized Official - Last Name:GILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:404-581-2662
Mailing Address - Street 1:1740 ROCKY CREEK RD # 3822
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31206-3585
Mailing Address - Country:US
Mailing Address - Phone:478-796-4896
Mailing Address - Fax:478-796-4896
Practice Address - Street 1:3781 JONES RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31216-6528
Practice Address - Country:US
Practice Address - Phone:404-581-2662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty