Provider Demographics
NPI:1285434415
Name:SYNAPTIC COVE MENTAL HEALTH
Entity type:Organization
Organization Name:SYNAPTIC COVE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:UY
Authorized Official - Last Name:DRIZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHMNP
Authorized Official - Phone:478-305-3198
Mailing Address - Street 1:103 COLUM CT
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2409
Mailing Address - Country:US
Mailing Address - Phone:478-305-3198
Mailing Address - Fax:
Practice Address - Street 1:103 COLUM CT
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2409
Practice Address - Country:US
Practice Address - Phone:478-305-3198
Practice Address - Fax:470-826-6434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty