Healthcare Provider Details

I. General information

NPI: 1164090676
Provider Name (Legal Business Name): DIONNE MAHAFFEY-MUHAMMAD PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIONNE MAHAFFEY PSYD

II. Dates (important events)

Enumeration Date: 06/12/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5887 GLENRIDGE DR STE 230
ATLANTA GA
30328-9929
US

IV. Provider business mailing address

5887 GLENRIDGE DR STE 230
SANDY SPRINGS GA
30328-9929
US

V. Phone/Fax

Practice location:
  • Phone: 404-390-4098
  • Fax: 877-427-2724
Mailing address:
  • Phone: 404-390-4098
  • Fax: 877-390-3830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC05236
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberTPMC8275
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05236
License Number StateAL
# 7
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 8
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC013361
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: