THREE RIVERS RECOVERY AND WELLNESS LLC
NPI 1699664060
Psychologist - Addiction (Substance Use Disorder) in Camilla, GA

Q: What is Three Rivers Recovery And Wellness LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Active since July 01, 2025CLIA 11D2325664 · Waiver

84 E OAKLAND AVE, CAMILLA, GA 31730(229) 336-9769 Get Directions Write a Review

NPPES record last updated: February 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 4, 2026, Jul 1, 2025 (2 updates tracked since 2025).

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About Three Rivers Recovery And Wellness Llc NPPES

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

THREE RIVERS RECOVERY AND WELLNESS LLC (NPI 1699664060) is a healthcare organization registered as an addiction (substance use disorder) in Camilla, Georgia and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through June 17, 2027 and lists Antonio Miller, President, as its authorized official.

NPPES Registry Identity

NPI1699664060

Entity TypeOrganization

Primary Taxonomy103TA0400X

Legal Business NameTHREE RIVERS RECOVERY AND WELLNESS LLC

Location Address84 E OAKLAND AVECamilla, GA 31730-1529

Mailing Address84 E Oakland AveCamilla, GA 31730-1529

Phone(229) 336-9769

Organization SubpartNo

Authorized OfficialAntonio MillerPresident · (229) 449-6671

Enumeration DateJuly 1, 2025

Last NPPES UpdateFebruary 4, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 4, 2026

✔ NPI 1699664060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code103TA0400X

Definition

A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.

84 E OAKLAND AVE, Camilla, GA 31730

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2325664

Three Rivers Recovery And Wellness · Camilla, GA

Active · expires Jun 17, 2027

CLIA Number11D2325664

Laboratory TypeOpiod Treatment Ctr

Certificate Effective DateJune 18, 2025

Certificate Expiration DateJune 17, 2027

Laboratory DirectorAntonio R. Miller

Laboratory Phone(229) 336-9769

Laboratory LocationThree Rivers Recovery And Wellness84 Eaast Oakland Avenue, Camilla, GA 31730

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Three Rivers Recovery And Wellness LLC's NPI number?

The NPI number for Three Rivers Recovery And Wellness LLC is 1699664060. It was assigned to this organization in the NPPES registry on July 1, 2025.

Where is Three Rivers Recovery And Wellness LLC located?

Three Rivers Recovery And Wellness LLC is located at 84 E Oakland Ave, Camilla, GA 31730. The listed phone number is (229) 336-9769.

What is Three Rivers Recovery And Wellness LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Does Three Rivers Recovery And Wellness LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2325664) is associated with this NPI, valid through June 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Three Rivers Recovery And Wellness LLC was last updated on February 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.