Healthcare Provider Details

I. General information

NPI: 1578498333
Provider Name (Legal Business Name): GOLDEN STRIDES BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 FIVE FORKS TRICKUM RD. SW #245 STE B9
LILBURN GA
30047-7630
US

IV. Provider business mailing address

4045 FIVE FORKS TRICKUM RD. SW #245 STE B9
LILBURN GA
30047-7630
US

V. Phone/Fax

Practice location:
  • Phone: 404-500-6760
  • Fax:
Mailing address:
  • Phone: 404-500-6760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HANNAH HAYES
Title or Position: OWNER
Credential: CPNP-AC/PC, PMHNP-BC
Phone: 404-500-6760