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General NPI Number Information
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NPI Number | 1528923430
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Entity Type | Organization
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Legal Business Name | PSYCHIATRY AND WELLNESS OF GEORGIA, LLC
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 4900 IVEY RD NW STE 1128
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City | ACWORTH
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State | GA
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Zip | 30101-4001
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Country | US
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Telephone | 678-439-0017
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Fax | 678-884-0761
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Provider Business Mailing Address
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Address Line | 620 COLONIAL PARK DR STE 100
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City | ROSWELL
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State | GA
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Zip | 30075-3839
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Country | US
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Telephone | 678-439-0017
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Fax | 678-884-0761
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Authorized Official
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Title or Position | CEO
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Name | JOHN MICHUKI KANYUIRA
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Credential |
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Telephone | 770-842-8701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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