The Mindful Match, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

THE MINDFUL MATCH, LLC

Practice address

528B Angier Ave NE
Atlanta, GA 30308-2902

Phone

(404) 913-3989

NPI assigned

Jul 23, 2020

Organization subpart

No

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

Authorized official

Name

Anjelica Francisco, LCSWNPI 1912431917

Title

Owner

Phone

(404) 913-3989

Specialties & licenses 2

Addresses

Practitioners 1

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

• Anjelica Francisco, LCSW

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1912431917
  NPD Authorized official

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1114536372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528B ANGIER AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082902",
            "telephone_number": "404-913-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528B ANGIER AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082902",
            "telephone_number": "404-913-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MINDFUL MATCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "FRANCISCO",
        "authorized_official_first_name": "ANJELICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-913-3989",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.