Organization Active NPI

Contemporary Healing Spaces, Inc

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1124784731
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CONTEMPORARY HEALING SPACES, INC
Practice address
691 John Wesley Dobbs Ave NE Ste V146
Atlanta, GA 30312-1690
Phone
(347) 639-8380
NPI assigned
Nov 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
Dominique Simone Marcus, LCSWNPI 1346836061
Title
Owner
Phone
(912) 430-7880

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

691 John Wesley Dobbs Ave NE Ste V146
Atlanta, GA 30312-1690

Mailing address

691 John Wesley Dobbs Ave NE Ste V146
Atlanta, GA 30312-1690
Phone (912) 430-7880

Other practice location 1

8914 Parsons Blvd Unit 5th
Jamaica, NY 11432-3576
Phone (912) 430-7880

National Provider Directory

National Provider Directory

Locations

8914 Parsons Blvd
Unit 5TH
Jamaica, NY 11432
Phone (912) 430-7880

Practitioners & affiliated clinicians

Practitioners 2

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": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1124784731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 JOHN WESLEY DOBBS AVE NE STE V146",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121690",
            "telephone_number": "912-430-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 JOHN WESLEY DOBBS AVE NE STE V146",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121690",
            "telephone_number": "347-639-8380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8914 Parsons Blvd Unit 5th",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114323576",
            "country_code": "US",
            "telephone_number": "912-430-7880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONTEMPORARY HEALING SPACES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_middle_name": "SIMONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-430-7880",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.