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General NPI Number Information
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NPI Number | 1578397287
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Entity Type | Organization
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Legal Business Name | BRIGHT IMPACT NOW PSYCHIATRY LLC
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Dates
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Enumeration Date | 08/27/2024
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 3400 CHAPEL HILL RD STE 325
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-1739
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Country | US
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Telephone | 470-613-1249
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Fax | 470-410-7199
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Provider Business Mailing Address
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Address Line | 3400 CHAPEL HILL RD STE 325
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-1739
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Country | US
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Telephone | 678-852-3203
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Fax | 470-410-7199
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | RETTA SUGARPEA BRIGHT
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Credential | NP
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Telephone | 678-852-3203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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