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General NPI Number Information
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NPI Number | 1285519827
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE MENTAL WELLNESS CARE
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 10/11/2025
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Provider Practice Location Address
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Address Line | 712 OAK ST # 5
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City | GAINESVILLE
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State | GA
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Zip | 30501-3510
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Country | US
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Telephone | 409-626-4133
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7
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City | GAINESVILLE
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State | GA
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Zip | 30503-0007
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Country | US
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Telephone | 470-892-4239
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Fax | 770-691-6655
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Authorized Official
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Title or Position | CEO
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Name | CAROLYN WILLIAMS
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Credential |
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Telephone | 470-892-4239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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