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General NPI Number Information
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NPI Number | 1003263914
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Entity Type | Organization
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Legal Business Name | FLOURISHING MINDS LLC
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Dates
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Enumeration Date | 05/20/2016
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 691 JOHN WESLEY DOBBS AVE NE UNIT C
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City | ATLANTA
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State | GA
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Zip | 30312-1669
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Country | US
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Telephone | 678-208-4885
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Fax | 678-922-2149
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Provider Business Mailing Address
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Address Line | 691 JOHN WESLEY DOBBS AVE NE UNIT C
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City | ATLANTA
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State | GA
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Zip | 30312-1669
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Country | US
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Telephone | 678-208-4885
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Fax | 678-922-2149
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Authorized Official
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Title or Position | OWNER
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Name | RIKKI CLARK MCCOY
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Credential | LCSW
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Telephone | 678-322-7935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | CSW005758
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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