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NPI Code Detail

MEDICARE: I DESERVE MENTAL WELLNESS SERVICES

MEDICARE: I DESERVE MENTAL WELLNESS SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1437830874
Entity Type Code : Organization
Provider Name (Legal Business Name) : I DESERVE MENTAL WELLNESS SERVICES
Provider Business Mailing Address
First Line : 2301 PEACHTREE LANDING CIR
Second Line :
City : FAIRBURN
State : GA
Zip : 30213-4270
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2301 PEACHTREE LANDING CIR
Second Line :
City : FAIRBURN
State : GA
Zip : 30213-4270
Country : US
Telephone Number : 404-482-0499
Fax Number :
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : SHENEE JOHNSON
Credential :
Telephone Number : 404-482-0499
Provider Enumeration Date : 07/27/2023
Last Update Date : 07/27/2023

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Directions to “I DESERVE MENTAL WELLNESS SERVICES ” Practice Location

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