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General NPI Number Information
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NPI Number | 1003435371
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Entity Type | Organization
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Legal Business Name | CLEAR MINDS FAMILY CENTER GEORGIA LLC
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 1050 CROWN POINTE PKWY
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City | DUNWOODY
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State | GA
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Zip | 30338-7707
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Country | US
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Telephone | 702-463-4000
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Fax | 702-463-4460
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Provider Business Mailing Address
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Address Line | 7 THE FARM RD
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City | MCDONOUGH
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State | GA
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Zip | 30252-5619
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Country | US
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Telephone | 702-809-7855
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONAL OFFICER
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Name | NASTAZIA GUY
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Credential |
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Telephone | 702-809-7855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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