Healthcare Provider Details

I. General information

NPI: 1912801416
Provider Name (Legal Business Name): MENTALLY FREE PSYCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W TRINITY PL
DECATUR GA
30030-3313
US

IV. Provider business mailing address

120 W TRINITY PL
DECATUR GA
30030-3313
US

V. Phone/Fax

Practice location:
  • Phone: 470-944-5699
  • Fax: 800-587-9985
Mailing address:
  • Phone: 470-944-5699
  • Fax: 800-587-9985

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: MS. SANTISSA CLAPP
Title or Position: CEO
Credential: NP
Phone: 470-944-5699