Healthcare Provider Details

I. General information

NPI: 1780420877
Provider Name (Legal Business Name): SOUND MIND PSYCHIATRIC SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 S DIXON ST
ALMA GA
31510-2704
US

IV. Provider business mailing address

204 S DIXON ST
ALMA GA
31510-2704
US

V. Phone/Fax

Practice location:
  • Phone: 912-387-2165
  • Fax: 866-811-4158
Mailing address:
  • Phone: 912-387-2165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY TURNER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 912-282-9063