Provider Demographics
NPI:1659406320
Name:PASTORAL CARE ASSOCIATES
Entity Type:Organization
Organization Name:PASTORAL CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:706-860-8860
Mailing Address - Street 1:863 SPARKLEBERRY RD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4427
Mailing Address - Country:US
Mailing Address - Phone:706-860-8860
Mailing Address - Fax:706-863-2829
Practice Address - Street 1:863 SPARKLEBERRY RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4427
Practice Address - Country:US
Practice Address - Phone:706-860-8860
Practice Address - Fax:706-863-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0017891041C0700X
SC67011041C0700X
GA000508106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1457372120OtherNPI
GA1356406391OtherNPI
GA80BBGGLMedicare PIN
GA1356406391OtherNPI