NPIMap

Organization Active NPI

Mended Minds, LLC

  • Community/Behavioral Health Agency
  • Smyrna, GA
National Provider Identifier
1023528635
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MENDED MINDS, LLC
Practice address
4027 Chariot Cir SE
Smyrna, GA 30080-5774
Phone
(404) 790-6527
NPI assigned
Oct 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary-Anne Adewakun, LPCNPI 1972950343
Title
Owner
Phone
(404) 790-6527

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4027 Chariot Cir SE
Smyrna, GA 30080-5774

Mailing address

4027 Chariot Cir SE
Smyrna, GA 30080-5774

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507507200000",
    "number": "1023528635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 CHARIOT CIR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 CHARIOT CIR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805774",
            "telephone_number": "404-790-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDED MINDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A",
        "authorized_official_last_name": "ADEWAKUN",
        "authorized_official_first_name": "MARY-ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-790-6527",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.