LIVING FULLY PSYCHOTHERAPY AND CONSULTING, LLC (NPI# 1215358015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215358015 |
| Entity Type | Organization |
| Organization Name | LIVING FULLY PSYCHOTHERAPY AND CONSULTING, LLC |
| Other Organization Name | LIVING FULLY |
| Practice Address |
1463 Oxford Rd Ne Atlanta GA 30322-1046 |
| Mailing Address |
553 Cobblestone Trl Avondale Estates GA 30002-1211 |
| Practice Telephone | 6785919117 |
| Mailing Telephone | 6785919117 |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2013-12-20 |
| Authorized Official Name | DR. PEGAH MOGHADDAM (OWNER/DIRECTOR) |
| Authorized Official Telephone | 6785919117 |
| Authorized Official Credential | PSY.D. |
| 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) |
PSY003405 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Living Fully | Other Name - Individual/Organization |
| Street Address |
1463 OXFORD RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30322-1046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445830 | Justin Gill | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Clinic B - Suite B6100, Atlanta, GA 30322 | 2019-06-12 |
| 1891354510 | Gwendolyn Gisiner Gunn | Genetic Counselor, MS | Emory Genetics Clinic, 1365 Clifton Road Ne, Atlanta, GA 30322 | 2019-06-06 |
| 1144710567 | Lisa Cathy-ann Akosa | Registered Nurse | 1365 Cifton Road Ne, Atlanta, GA 30322 | 2018-05-10 |
| 1083118004 | Jessica Milian Keilson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne, Suite H100, Emory University Hospital Office of Surgical Education, Atlanta, GA 30322 | 2018-03-23 |
| 1568982684 | Jennifer Bilko | Dietitian, Registered | 1365 Clifton Rd., Bldg A, 1st Floor, Suite 1450, Atlanta, GA 30322 | 2017-06-20 |
| 1134652258 | Kassahun Bilcha | Student in an Organized Health Care Education/Training Program | 1525 Clifton Rd Ne Ste 100, Atlanta, GA 30322 | 2017-04-05 |
| 1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1427404904 | Rita Kaur Kuwahara | Student in an Organized Health Care Education/Training Program | 100 Woodruff Circle, Suite 327, Atlanta, GA 30322 | 2016-05-13 |
| 1891176251 | Octav Cristea | Transplant Surgery | 1365 Clifton Road Northeast, Building B, 6th Floor, Atlanta, GA 30322 | 2015-06-11 |
| Find all providers in zip 30322 | ||||
| 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 |
| 1205471695 | Mindbrain Institute of Atlanta | Clinic/Center | 2200 Century Pkwy Ne Ste 200, Atlanta, GA 30345-3103 | 2019-11-09 |
| 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 |
| 1225373145 | The Renfrew Centers, Inc. | Clinic/Center | 50 Glenlake Parkway Ne, Suite 120, Atlanta, GA 30328 | 2012-12-04 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on LIVING FULLY PSYCHOTHERAPY AND CONSULTING, LLC.
| 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.