Mindbrain Institute of Atlanta

Primary specialty

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

Legal business name

MINDBRAIN INSTITUTE OF ATLANTA

Doing business as

MindBrain Institute of Atlanta

Practice address

2200 Century Pkwy NE Ste 200
Atlanta, GA 30345-3103

Phone

(404) 692-7027

NPI assigned

Nov 9, 2019

Organization subpart

No

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

Authorized official

Name

Diana Holberg Gordick, PHDNPI 1356672331

Title

Owner/Clinical Director

Phone

(404) 692-7027

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MindBrain Institute of Atlanta Doing business as

Practitioners 1

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

• Diana Holberg Gordick, PH.D.

  • Counseling Psychologist
  • Decatur, GA
  • NPI 1356672331
  NPD Authorized official

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

{
    "created_epoch": "1573257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573257600000",
    "number": "1205471695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 CENTURY PKWY NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453103",
            "telephone_number": "404-692-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CENTURY PKWY NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453103",
            "telephone_number": "404-692-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDBRAIN INSTITUTE OF ATLANTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-09",
        "last_updated": "2019-11-09",
        "status": "A",
        "authorized_official_last_name": "GORDICK",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "HOLBERG",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "404-692-7027",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1356672331",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MindBrain Institute of Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mind Body Spirit Wellness Inc
• Mind Body Works LLC
• Mind Restoration, LLC
• Mind, Body, Peace LLC
• Mind's Eye Enterprises, LLC
• Mindful Discovery Therapeutic Solutions
• Mindful Healing Health and Wellness
• Mindful Life Services LLC
• Mindful Medicine Integrative Care, LLC (Mindful Medicine)
• Mindful Therapy Works, LLC

• 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 Nov 9, 2019; 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.