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General NPI Number Information
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NPI Number | 1215597182
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Entity Type | Organization
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Legal Business Name | MIND FAMILY & SOCIAL SERVICES, INC
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 153 LEE BYRD RD # 3
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City | LOGANVILLE
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State | GA
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Zip | 30052-2310
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Country | US
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Telephone | 708-897-7449
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Fax |
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Provider Business Mailing Address
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Address Line | 1123 BALTIC CT # 3
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City | LOGANVILLE
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State | GA
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Zip | 30052-6762
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Country | US
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Telephone | 678-587-5918
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. CHERYL LOCKETT
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Credential | PHD
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Telephone | 678-587-5918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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