Summerville, Mary Beth

Summerville, Mary Beth is an sole proprietor health care provider with primary practice located at 680 Douthit Ferry Rd Suite 106, Cartersville GA 30120-4150. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Summerville, Mary Beth can be contacted via phone (770) 334-8461.

Contact Information

Primary practice address
680 Douthit Ferry Rd Suite 106 Cartersville GA 30120-4150
Phone: (770) 334-8461
Fax: (770) 334-8624
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY001432 Georgia

Profile Details

NPI number 1508946195
LBN Legal business name Summerville, Mary Beth
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2006
Last updated Jun 29th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508946195 NPPES
Georgia MEDICAID 000462294D

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