Healthcare Provider Details
I. General information
NPI: 1114683851
Provider Name (Legal Business Name): CURATIVE MINDSET COACHING HEALING & HUMAN SERVICE CONSULTANCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2021
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
745 MULLINAX RD
ALPHARETTA GA
30004-7724
US
IV. Provider business mailing address
575 PHARR RD NE UNIT 12285
ATLANTA GA
30355-4031
US
V. Phone/Fax
- Phone: 678-453-7700
- Fax:
- Phone: 678-453-7700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: PROF.
SHARON
LIZ
REED
Title or Position: CLINICIAN
Credential: MD
Phone: 678-453-7700