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General NPI Number Information
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NPI Number | 1568238202
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Entity Type | Organization
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Legal Business Name | KINDLE MENTAL, LLC.
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 5755 N POINT PKWY STE 59
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City | ALPHARETTA
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State | GA
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Zip | 30022-1145
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Country | US
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Telephone | 770-864-4867
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2722
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City | ALPHARETTA
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State | GA
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Zip | 30023-2722
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Country | US
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Telephone | 770-864-4867
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MR. JOE NATHAN JOHNSON JR.
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Credential | MBA, M.S., LPC
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Telephone | 770-864-4867
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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