Healthcare Provider Details

I. General information

NPI: 1104759497
Provider Name (Legal Business Name): MINDSET BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4171 MARIETTA ST STE 300B
POWDER SPRINGS GA
30127-4808
US

IV. Provider business mailing address

4234 DEFOORS FARM TRL
POWDER SPRINGS GA
30127-4067
US

V. Phone/Fax

Practice location:
  • Phone: 770-508-9018
  • Fax:
Mailing address:
  • Phone: 770-508-9018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ZANTHIA BIVINS
Title or Position: OWNER/DIRECTOR
Credential: ED.S, M.ED
Phone: 770-508-9018