Healthcare Provider Details

I. General information

NPI: 1114838992
Provider Name (Legal Business Name): GREAT MINDS MENTAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL # 12147
SANDY SPRINGS GA
30350-2995
US

IV. Provider business mailing address

8735 DUNWOODY PL # 12147
SANDY SPRINGS GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 478-739-5254
  • Fax: 478-215-8219
Mailing address:
  • Phone: 478-739-5254
  • Fax: 478-215-8219

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: TAMARA JEANINE SMITH
Title or Position: PMHNP
Credential: PMHNP-BC
Phone: 478-739-5254