Play 21 Wellness Academy LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PLAY 21 WELLNESS ACADEMY LLC

Practice address

3580 Breckinridge Blvd Ste 104
Duluth, GA 30096-5256

Phone

(770) 680-5642

NPI assigned

Jun 5, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Kurt Jones, PHD

Title

Ceo

Phone

(703) 347-5887

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1215821996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 BRECKINRIDGE BLVD STE 104",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965256",
            "telephone_number": "770-680-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 BRECKINRIDGE BLVD STE 104",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965256",
            "telephone_number": "770-680-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAY 21 WELLNESS ACADEMY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-347-5887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.