Mindrise, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDRISE, LLC

Practice address

1220 Pennsylvania Ave
McDonough, GA 30253-8999

Phone

(470) 593-0720

NPI assigned

Dec 23, 2021

Organization subpart

No

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

Authorized official

Name

Shelly-Anne Johnson

Title

Owner/Therapist

Phone

(470) 593-0720

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1255091815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 HIGHWAY 85 N STE 310-446",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147738",
            "telephone_number": "470-593-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 PENNSYLVANIA AVE",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538999",
            "telephone_number": "470-593-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHELLY-ANNE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "470-593-0720"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Miller, LPC
• Shelley Mills
• Tricia Mills, CADC II
• Mindful Milestones ABA LLC
• Mindful Realizations Counseling & Consulting LLC
• Bryan Miner
• Regina Nicole Minor, FNP
• Miracles Start Here LLC
• Amina Mirza
• Jennifer Mitchell, PMHNP

• Clinical Social Worker in McDonough, GA
• Providers in McDonough, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.