CLAYTON MHDDAD NPI 1639367543

NPI Information

  • NPI: 1639367543
  • Provider Name: CLAYTON MHDDAD
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Doing Business As: CLAYTON CSB
  • Address: 6315 GARDEN WALK BLVD
    RIVERDALE, GA
    ZIP 30274
  • Phone: (770) 991-7420

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NPI Details

CLAYTON MHDDAD is a community behavioral health in Riverdale, GA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. CLAYTON MHDDAD NPI is 1639367543. The provider is registered as an organization entity type.
The provider Is Doing Business As Clayton Csb.

The provider's business location address is:

6315 GARDEN WALK BLVD
RIVERDALE, GA
ZIP 30274-628
Phone: (770) 991-7420
Fax: (770) 991-7429

The provider's authorized official is Terry Cole .
The authorized official title is Excutive 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 11/8/2011.

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)No
2251C00000XDay Training, Developmentally Disabled ServicesNo
3261Q00000XClinic/CenterNo
4261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
5101Y00000XCounselorNo
6101YA0400XCounselorAddiction (Substance Use Disorder)No
7103TC2200XPsychologistClinical Child & AdolescentNo
8103T00000XPsychologistNo
9251S00000XCommunity/Behavioral HealthYes

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
1GRP2322MEDICARE PINGEORGIA
2000604250BMEDICAIDGEORGIA
300604205BMEDICAIDGEORGIA

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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