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General NPI Number Information
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NPI Number | 1548728777
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Entity Type | Organization
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Legal Business Name | A MIND WITHOUT BORDERS LLC
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 4029 EGYPT RD
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City | SNELLVILLE
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State | GA
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Zip | 30039-6494
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Country | US
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Telephone | 678-961-8144
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Fax | 678-961-8079
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Provider Business Mailing Address
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Address Line | 4029 EGYPT RD
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City | SNELLVILLE
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State | GA
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Zip | 30039-6494
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Country | US
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Telephone | 678-961-8144
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Fax | 678-961-8079
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Authorized Official
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Title or Position | DIRECTOR
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Name | CAMELLE M BAYNES
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Credential |
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Telephone | 678-961-8144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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