Healthcare Provider Details

I. General information

NPI: 1225625528
Provider Name (Legal Business Name): A BEAUTIFUL MIND MENTAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WOODMONT LN NW STE 4497
ATLANTA GA
30318-2866
US

IV. Provider business mailing address

1445 WOODMONT LN NW STE 4497
ATLANTA GA
30318-2866
US

V. Phone/Fax

Practice location:
  • Phone: 229-364-2375
  • Fax:
Mailing address:
  • Phone: 229-364-2375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: YOLANDA WILLIAMS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 229-347-1758