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NPI 1417811720

NPI 1417811720 : MAGIC FEATHER MENTAL HEALTH LLC : MARIETTA, GA

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General NPI Number Information
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    NPI Number           |    1417811720
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    Entity Type          |    Organization 
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    Legal Business Name  |    MAGIC FEATHER MENTAL HEALTH LLC 
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Dates
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    Enumeration Date     |    12/11/2025
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    Last Update Date     |    12/11/2025
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Provider Practice Location Address
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    Address Line         |    2480 WINDY HILL RD SE STE 210 
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    City                 |    MARIETTA
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    State                |    GA
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    Zip                  |    30067-8644
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    Country              |    US
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    Telephone            |    404-496-8606
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    555 SUN VALLEY DR STE G4 
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    City                 |    ROSWELL
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    State                |    GA
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    Zip                  |    30076-5607
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    Country              |    US
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    Telephone            |    404-496-8606
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     BETH MARIE MILLER 
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    Credential           |    LCSW
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    Telephone            |    404-496-8606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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