MARVELOUSLY ADORNED, LLC (NPI# 1023521473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023521473 |
| Entity Type | Organization |
| Organization Name | MARVELOUSLY ADORNED, LLC |
| Practice Address |
2011 Commerce Dr N Peachtree City GA 30269-3538 |
| Mailing Address |
Po Box 84 Tyrone GA 30290-0084 |
| Practice Telephone | 4703059772 |
| Mailing Telephone | 4703059772 |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |
| Authorized Official Name | LASHANDA L JOHNSON (THERAPIST/CLINICAN/COUNSELOR) |
| Authorized Official Telephone | 4703059772 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | CSW005680 | GA | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW005680 | GA | Behavioral Health & Social Service Providers |
| Street Address |
2011 COMMERCE DR N |
| City | PEACHTREE CITY |
| State | GA |
| Zip Code | 30269-3538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952368425 | Alison Baker | Psychiatry & Neurology | 2011 Commerce Dr N, Suite A106, Peachtree City, GA 30269-3538 | 2006-04-28 |
| 1689159980 | Integrated Care Resources of Georgia, LLC | Case Management | 2011 Commerce Dr N, Peachtree City, GA 30269-3538 | 2018-10-02 |
| 1326529157 | Integrated Care Resources, Inc | Clinic/Center | 2011 Commerce Dr N, Peachtree City, GA 30269-3538 | 2018-08-29 |
| 1740793199 | Lashanda L. Johnson | Social Worker | 2011 Commerce Dr N, Peachtree City, GA 30269-3538 | 2017-11-08 |
| 1932650884 | Jason Mcdowell | Nurse Practitioner | 2011 Commerce Dr N, Peachtree City, GA 30269-3538 | 2016-10-16 |
| 1033561956 | Edens Health Group Lawrenceville | General Practice | 2011 Commerce Dr N, Suite 25, Peachtree City, GA 30269-3538 | 2016-07-02 |
| 1053706531 | Gomed, LLC | General Practice | 2011 Commerce Dr N, Suite 25, Peachtree City, GA 30269-3538 | 2015-04-01 |
| 1245649581 | Mia Y Wright | Social Worker | 2011 Commerce Dr N, Peachtree City, GA 30269-3538 | 2014-08-12 |
| 1417363797 | Dr 2 Travel, LLC | Clinic/Center | 2011 Commerce Dr N, Suite 21, Peachtree City, GA 30269-3538 | 2014-07-07 |
| 1396169959 | Monica L. Bell-callahan | Counselor | 2011 Commerce Dr N, Peachtree City, GA 30269-3538 | 2014-02-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750992772 | Brian Voyles | Pharmacist | 130 Peachtree East Ct, Ste #4, Peachtree City, GA 30269 | 2020-08-13 |
| 1871133066 | Imani Scott | Physical Therapist | 1280 Hwy 74 S Ste 210, Peachtree City, GA 30269 | 2020-01-15 |
| 1477191898 | Sandra Jo Aletraris | Counselor | 105 Camp Creek Trail, Peachtree City, GA 30269 | 2019-12-16 |
| 1295372696 | Jovon Erika Caldwell Taylor | Nurse Practitioner | 125 Governors Square, Suite B, Peachtree City, GA 30269 | 2019-12-04 |
| 1376191106 | Ryan Goldfine Dpm LLC | Podiatrist | 3451 Ernest W Barrett Pkwy Suite 170, Mariettta, GA 30269 | 2019-08-26 |
| 1740834092 | Shenitta Guyton | Psychologist | 619 Grecken Grn, Peachtree City, GA 30269 | 2019-07-25 |
| 1063971463 | Sarah Elizabeth Epps | Speech-Language Pathologist | 156 Peachtree East #149, Peachtree City, GA 30269 | 2019-03-15 |
| 1689139362 | Resiliency Behavioral Health Services LLC | Counselor | 145 Govenors Square, Ste A, Fayetteville, GA 30269 | 2019-02-06 |
| 1790256931 | Change of Life Companion Homecare LLC | Nurse Anesthetist, Certified Registered | 401 Topaz Trail, Peachtree City, Fayetteville, GA 30269 | 2018-12-16 |
| 1447753686 | Kelli M Shelton | Counselor | 145 A Governor's Sq., Peachtree City, GA 30269 | 2018-03-14 |
| Find all providers in zip 30269 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588156418 | Kimela Boone | Social Worker | 403 Plantain Ter, Peachtree City, GA 30269-4026 | 2018-06-06 |
| 1205336674 | Sharon Wallace Brooks | Social Worker | 108 Roundleaf Ct, Peachtree City, GA 30269-1240 | 2018-02-12 |
| 1346754215 | Mary Imani Brooks | Social Worker | 700 S Fairfield Dr, Peachtree City, GA 30269 | 2017-11-29 |
| 1013454024 | H.e.a.r.t. Center for Families, LLC | Social Worker | 60b Eastbrook Bnd, Peachtree City, GA 30269-1530 | 2017-01-28 |
| 1710361944 | Jill Pietrzakowski Jones | Social Worker | 277 Ga-74 N, #306, Peachtree City, GA 30269 | 2015-07-17 |
| 1821437005 | Stephanie Butcher Mezei | Social Worker | 200 Westpark Dr Ste 120, Peachtree City, GA 30269-1447 | 2013-06-20 |
| 1831479518 | Katherine Rae Best Formel | Social Worker | 160 Terrane Rdg, Peachtree City, GA 30269-6604 | 2011-08-25 |
| 1114220183 | Melissa Zipfel Williams | Social Worker | 111 Petrol Point, Suite B6, Peachtree City, GA 30269 | 2010-12-14 |
| 1215243696 | Camber P Dougher | Social Worker | 111 Petrol Pt Ste 202, Peachtree City, GA 30269-1553 | 2010-08-24 |
| 1013158633 | Naomi L Duncan | Social Worker | 300 Tivoli Gardens Rd, Peachtree City, GA 30269-1557 | 2009-03-11 |
| Find all providers in PEACHTREE CITY | ||||
| City | PEACHTREE CITY |
| Zip Code | 30269 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.