MINDBRAIN INSTITUTE OF ATLANTA (NPI# 1205471695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205471695 |
| Entity Type | Organization |
| Organization Name | MINDBRAIN INSTITUTE OF ATLANTA |
| Practice Address |
2200 Century Pkwy Ne Ste 200 Atlanta GA 30345-3103 |
| Practice Telephone | 4046927027 |
| Mailing Telephone | 4046927027 |
| Enumeration Date | 2019-11-09 |
| Last Update Date | 2019-11-09 |
| Authorized Official Name | DIANA HOLBERG GORDICK (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Telephone | 4046927027 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI 1 | 1356672331 | 01 |
| Other Name | Type Code |
|---|---|
| MindBrain Institute of Atlanta | Doing Business As Name - Organization |
| Street Address |
2200 CENTURY PKWY NE STE 200 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30345-3103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306358726 | Marian Barton Kalvert | Counselor | 2300 Henderson Mill Rd Ne Ste 310, Atlanta, GA 30345 | 2017-10-25 |
| 1417478439 | Reexist Counseling LLC | Clinic/Center | 1955 Vance Drive Ne, Atlanta, GA 30345 | 2017-06-29 |
| 1366862930 | Creative Behavior Consulting | Counselor | 6212 Northlake Circle Ne, Atlanta, GA 30345 | 2014-04-22 |
| 1215375209 | Shakeia Cowan | Counselor | 2302 Parklake Drive, Suite 350, Atlanta, GA 30345 | 2013-06-12 |
| 1154673259 | Phyllis Carrera | Counselor | 1788-b Century Blvd, Atlanta, GA 30345 | 2012-10-12 |
| 1417216128 | Procare Pharmacy, LLC | Pharmacy | 2700 Northeast Expy Ne, Suite B-800, Atlanta, GA 30345 | 2012-05-15 |
| 1962794479 | Nicole Renee Buttery | Behavioral Analyst | 1776 Century Blvd Ne Ste A, Atlanta, GA 30345 | 2011-05-03 |
| 1972839371 | Barbara Lopes Cardozo | Psychiatry & Neurology | 2500 Century Blvd, Mailstop V 25-1, Atlanta, GA 30345 | 2009-10-20 |
| 1568615193 | Zouheir A Shama Sr. | Surgery | 2536 Cosmos Drive N.e., Atlanta, GA 30345 | 2008-10-28 |
| 1396930558 | Munir Kashlan | Dentist | 4800 Briarcliff Rd, Ste 2037 American Dental Group Dba Great Expressions, Atlanta, GA 30345 | 2007-09-11 |
| Find all providers in zip 30345 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124632013 | Dunwoody Mental Health Center | Clinic/Center | 4594 Barclay Dr, Atlanta, GA 30338-5883 | 2020-09-08 |
| 1972120970 | Imagine New Beginnings | Clinic/Center | 3125 Colonial Way Apt J, Atlanta, GA 30341-5339 | 2020-06-25 |
| 1659994705 | Paul Smith Counseling and Consulting, LLC | Clinic/Center | 5180 Roswell Rd Ste 106, Atlanta, GA 30342-2293 | 2020-05-24 |
| 1568091429 | Keystone Behavioral Health Center | Clinic/Center | 3071 Campbellton Rd Sw Ste 2, Atlanta, GA 30311-5441 | 2020-04-03 |
| 1528613437 | Kenetta Muhammad | Clinic/Center | 801 Joseph E Boone Blvd Nw, Atlanta, GA 30314-3344 | 2019-08-07 |
| 1356906929 | Lenox Pointe Psychotherapy, LLC | Clinic/Center | 6 Lenox Pointe Ne, Atlanta, GA 30324-3167 | 2019-05-08 |
| 1205352093 | Elite Rose Healthcare Services P.C. | Clinic/Center | 2783 Santa Barbara Dr Nw, Atlanta, GA 30318-7326 | 2017-08-14 |
| 1417478439 | Reexist Counseling LLC | Clinic/Center | 1955 Vance Drive Ne, Atlanta, GA 30345 | 2017-06-29 |
| 1215358015 | Living Fully Psychotherapy and Consulting, LLC | Clinic/Center | 1463 Oxford Rd Ne, Atlanta, GA 30322-1046 | 2013-12-20 |
| 1225373145 | The Renfrew Centers, Inc. | Clinic/Center | 50 Glenlake Parkway Ne, Suite 120, Atlanta, GA 30328 | 2012-12-04 |
| Find all providers in ATLANTA | ||||
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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.