NPIMap

Organization Active NPI

Wind From the Mountain Renewal Center, P.C.

  • Clinical Psychologist
  • Cherry Log, GA
National Provider Identifier
1245404599
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1377 Issued in GA
Legal business name
WIND FROM THE MOUNTAIN RENEWAL CENTER, P.C.
Practice address
740 Little Rock Creek Rd
Cherrylog, GA 30522-2904
Phone
(706) 635-8200
Fax
(706) 635-8201
NPI assigned
Apr 17, 2008
Last updated
Apr 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Authorized official

Name
Cara M Busch
Title
Office Manager
Phone
(706) 635-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 1377 GA Primary

Addresses

Primary practice location

740 Little Rock Creek Rd
Cherrylog, GA 30522-2904

Mailing address

740 Little Rock Creek Rd
Cherrylog, GA 30522-2904
Phone (706) 635-8200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1245404599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 LITTLE ROCK CREEK RD",
            "city": "CHERRYLOG",
            "state": "GA",
            "postal_code": "305222904",
            "telephone_number": "706-635-8200",
            "fax_number": "706-635-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 LITTLE ROCK CREEK RD",
            "city": "CHERRYLOG",
            "state": "GA",
            "postal_code": "305222904",
            "telephone_number": "706-635-8200",
            "fax_number": "706-635-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIND FROM THE MOUNTAIN RENEWAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "CARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-635-8200"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Log, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.