Provider Demographics
NPI:1710741699
Name:GARRISON, MACHION SAMUEL III (CCIT)
Entity Type:Individual
Prefix:MR
First Name:MACHION
Middle Name:SAMUEL
Last Name:GARRISON
Suffix:III
Gender:M
Credentials:CCIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 LEXINGTON VLG
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-6858
Mailing Address - Country:US
Mailing Address - Phone:832-496-0733
Mailing Address - Fax:
Practice Address - Street 1:803 LEXINGTON VLG
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6858
Practice Address - Country:US
Practice Address - Phone:832-496-0733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor