Healthcare Provider Details

I. General information

NPI: 1932045671
Provider Name (Legal Business Name): MINDFUL SOLUTIONS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 VILLAGE TRCE NE BLDG 15E
MARIETTA GA
30067-1516
US

IV. Provider business mailing address

630 VILLAGE TRCE NE BLDG 15E
MARIETTA GA
30067-1516
US

V. Phone/Fax

Practice location:
  • Phone: 678-382-2916
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ELYSE BRYMAN
Title or Position: FOUNDER/ THERAPIST
Credential: LCSW
Phone: 678-382-2916