Provider Demographics
NPI:1548521727
Name:SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC.
Entity type:Organization
Organization Name:SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHEHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-546-9265
Mailing Address - Street 1:P.O. BOX 8406
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35902
Mailing Address - Country:US
Mailing Address - Phone:256-546-9265
Mailing Address - Fax:256-549-0376
Practice Address - Street 1:3001 SCENIC HIGHWAY
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35904
Practice Address - Country:US
Practice Address - Phone:256-413-1880
Practice Address - Fax:256-413-1882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-04
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL201292924101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty