Healthcare Provider Details

I. General information

NPI: 1912623687
Provider Name (Legal Business Name): NORTHVIEW WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 HOLCOMB BRIDGE RD
NORCROSS GA
30071-1375
US

IV. Provider business mailing address

1801 PEACHTREE ST NE STE 300
ATLANTA GA
30309-1859
US

V. Phone/Fax

Practice location:
  • Phone: 678-626-1868
  • Fax: 678-626-1898
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA COTHERN
Title or Position: ADMINISTRATOR
Credential:
Phone: 770-298-2490