NPI Code Details Logo

NPI 1780525501

NPI 1780525501 : INDIGO HEALING MINDS LLC : LITHIA SPRINGS, GA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1780525501
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    INDIGO HEALING MINDS LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/04/2026
-----------------------------------------------------
    Last Update Date     |    04/04/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    675 THORNTON WAY STE A 
-----------------------------------------------------
    City                 |    LITHIA SPRINGS
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30122-2635
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    347-489-7495
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    675 THORNTON WAY STE A 
-----------------------------------------------------
    City                 |    LITHIA SPRINGS
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30122-2635
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PROVIDER
-----------------------------------------------------
    Name                 |     KAMIKA  HAMILTON 
-----------------------------------------------------
    Credential           |    PMHNP-BC
-----------------------------------------------------
    Telephone            |    347-489-7495
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QM0801X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.