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General NPI Number Information
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NPI Number | 1669108346
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Entity Type | Organization
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Legal Business Name | CARE OF THE MIND, LLC
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 10945 STATE BRIDGE RD
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City | ALPHARETTA
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State | GA
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Zip | 30022
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Country | US
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Telephone | 678-561-7417
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Fax |
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Provider Business Mailing Address
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Address Line | 11585 JONES BRIDGE RD STE. 420, PMB 1168
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City | JOHNS CREEK
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State | GA
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Zip | 30022-7476
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Country | US
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Telephone | 678-561-7417
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Fax |
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Authorized Official
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Title or Position | ORGANIZER/OWNER
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Name | SARA YOUNG
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Credential | LCSW
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Telephone | 678-561-7417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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