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General NPI Number Information
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NPI Number | 1689542888
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Entity Type | Organization
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Legal Business Name | MINDFUL STAGES
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 3000 LANGFORD RD STE 400
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30071-4773
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Country | US
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Telephone | 404-913-4212
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Fax | 404-523-9444
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Provider Business Mailing Address
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Address Line | 3000 LANGFORD RD STE 400
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30071-4773
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Country | US
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Telephone | 404-913-4212
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Fax | 404-523-9444
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Authorized Official
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Title or Position | EDUCATIONAL PSYCHOLOGIST/OWNER
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Name | TYLINA SWINGER
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Credential | PHD
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Telephone | 404-913-4212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 224ZE0001X
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Taxonomy Name | Environmental Modification Occupational Therapy Assistant
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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