CLAYTON MHDDAD NPI 1629266473

NPI Information

  • NPI: 1629266473
  • 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: 4513 ERNEST DR
    APT. # 1 & 3
    FOREST PARK, GA
    ZIP 30297
  • Phone: (404) 363-2063

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NPI Details

CLAYTON MHDDAD is a mental health (including community mental health center) clinic center in Forest Park, GA. CLAYTON MHDDAD NPI is 1629266473. The provider is registered as an organization entity type.
The provider Is Doing Business As Clayton Csb.

The provider's business location address is:

4513 ERNEST DR
APT. # 1 & 3
FOREST PARK, GA
ZIP 30297-566
Phone: (404) 363-2063

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 10/5/2007 and was last updated on 11/15/2011.

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
100604205LMEDICAIDGEORGIA
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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