Healthcare Provider Details

I. General information

NPI: 1346723046
Provider Name (Legal Business Name): JHADRIAN WYNTER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 01/27/2023
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 CARPENTER DR STE 400
ATLANTA GA
30328-4933
US

IV. Provider business mailing address

267 LANGLEY DR # 1107
LAWRENCEVILLE GA
30046-6907
US

V. Phone/Fax

Practice location:
  • Phone: 678-460-0345
  • Fax:
Mailing address:
  • Phone: 786-260-1288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: