Exalt the Light, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EXALT THE LIGHT, LLC

Practice address

5204 Westchester Lane, NE
Atlanta, GA 30345

Phone

(470) 236-9050

NPI assigned

Feb 23, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Imani Sade' Hines, LPCNPI 1255960662

Title

Clinician/Ceo

Phone

(470) 236-1746

Specialties & licenses 1

Addresses

Practitioners 1

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

• Imani Sade Hines, LPC

  • Mental Health Counselor
  • Atlanta, GA
  • NPI 1255960662
  NPD Authorized official

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1124884531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NORTHSIDE DRIVE NW SUITE A7 PMB 2480",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30318",
            "telephone_number": "470-236-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 WESTCHESTER LANE, NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30345",
            "telephone_number": "470-236-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXALT THE LIGHT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "IMANI",
        "authorized_official_middle_name": "SADE'",
        "authorized_official_title_or_position": "CLINICIAN/CEO",
        "authorized_official_telephone_number": "470-236-1746",
        "authorized_official_name_prefix": "Ms.",
        "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.