NPIMap

Organization Active NPI

Mimi McDonald LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Woodstock, GA
National Provider Identifier
1104437987
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MIMI MCDONALD LLC
Practice address
405 Creekstone RDG
Woodstock, GA 30188-3746
Phone
(470) 798-0202
Fax
(470) 410-7602
NPI assigned
Aug 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Janet Mimi McDonald, LPCNPI 1932487097
Title
Owner
Phone
(470) 798-0202

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

405 Creekstone RDG
Woodstock, GA 30188-3746

Mailing address

405 Creekstone RDG
Woodstock, GA 30188-3746
Phone (470) 798-0202

Other names 1

  • Haven Counseling Center Doing business as

National Provider Directory

National Provider Directory

Locations

408 Creekstone Rdg
Woodstock, GA 30188
Phone (404) 850-1955

405 Creekstone Rdg
Woodstock, GA 30188
Phone (470) 798-0202

Practitioners & affiliated clinicians

Practitioners 4

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": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1104437987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883746",
            "telephone_number": "470-798-0202",
            "fax_number": "470-410-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883746",
            "telephone_number": "470-798-0202",
            "fax_number": "470-410-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIMI MCDONALD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-06-09",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "MIMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-798-0202",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Haven Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.