Healthcare Provider Details

I. General information

NPI: 1235825035
Provider Name (Legal Business Name): GAINESVILLE MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2565 THOMPSON BRIDGE RD STE 111
GAINESVILLE GA
30501-1723
US

IV. Provider business mailing address

3820 GREY ABBEY DR
ALPHARETTA GA
30022-6481
US

V. Phone/Fax

Practice location:
  • Phone: 470-839-5845
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MUHAMMAD ALI PERVAIZ
Title or Position: OWNER
Credential: MD, MSIT
Phone: 914-316-4218