CLAYTON MHDDAD NPI 1306034012

NPI Information

  • NPI: 1306034012
  • Provider Name: CLAYTON MHDDAD
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Doing Business As: CLAYTON CSB
  • Address: 8132 KENDRICK RD
    B&C
    JONESBORO, GA
    ZIP 30238
  • Phone: (770) 471-5249

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NPI Details

CLAYTON MHDDAD is a mental health (including community mental health center) clinic center in Jonesboro, GA. CLAYTON MHDDAD NPI is 1306034012. The provider is registered as an organization entity type.
The provider Is Doing Business As Clayton Csb.

The provider's business location address is:

8132 KENDRICK RD
B&C
JONESBORO, GA
ZIP 30238-933
Phone: (770) 471-5249
Fax: (770) 477-9772

The provider's authorized official is Terry Cole .
The authorized official title is Executive Director and has the following contact phone number (770) 478-2280.

The enumeration date for this NPI number is 10/9/2007 and was last updated on 11/8/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100604205QMEDICAIDGEORGIA
2GRP2322MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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