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PSYCH PRACTICE LLC
NPI 1689060790
Community/Behavioral Health in Douglas, GA

Active since April 15, 2015
410 SHIRLEY AVE, DOUGLAS, GA 31533(912) 260-1206(912) 383-7820 Get Directions Write a Review

NPPES record last updated: April 15, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Psych Practice Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PSYCH PRACTICE LLC (NPI 1689060790) is a healthcare organization registered as a community/behavioral health in Douglas, Georgia and active in the NPI registry since April 2015. The organization lists Mubbashir M Khan, Ceo/ M.d, as its authorized official.

NPPES Registry Identity

NPI1689060790
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NamePSYCH PRACTICE LLC
Location Address410 SHIRLEY AVEDouglas, GA 31533-2002
Mailing Address410 Shirley AveDouglas, GA 31533-2002 · (912) 260-1206 · Fax (912) 383-7820
Phone(912) 260-1206
Fax(912) 383-7820
Organization SubpartNo
Authorized OfficialMubbashir M KhanCeo/ M.d · (912) 260-1206
Enumeration DateApril 15, 2015
✔ NPI 1689060790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in GA · 054327
Definition
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.
410 SHIRLEY AVE, Douglas, GA 31533
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Other Identifiers 1

Medicaid003120037DGA

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MUBBASHIR MUZZAMMIL KHAN MD
Psychiatry & Neurology (Psychiatry)
410 SHIRLEY AVE
DOUGLAS, GA 31533
Coffee County (912) 260-1206

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Psych Practice LLC's NPI number?

The NPI number for Psych Practice LLC is 1689060790. It was assigned to this organization in the NPPES registry on April 15, 2015.

Where is Psych Practice LLC located?

Psych Practice LLC is located at 410 Shirley Ave, Douglas, GA 31533. The listed phone number is (912) 260-1206.

What is Psych Practice LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Psych Practice LLC was last updated on April 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.