Healthcare Provider Details

I. General information

NPI: 1003263914
Provider Name (Legal Business Name): FLOURISHING MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 JOHN WESLEY DOBBS AVE NE UNIT C
ATLANTA GA
30312-1669
US

IV. Provider business mailing address

691 JOHN WESLEY DOBBS AVE NE UNIT C
ATLANTA GA
30312-1669
US

V. Phone/Fax

Practice location:
  • Phone: 678-208-4885
  • Fax: 678-922-2149
Mailing address:
  • Phone: 678-208-4885
  • Fax: 678-922-2149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCSW005758
License Number StateGA

VIII. Authorized Official

Name: RIKKI CLARK MCCOY
Title or Position: OWNER
Credential: LCSW
Phone: 678-322-7935