Organization Active NPI

Healthy Minds Psychology Associates Inc

  • Psychologist
  • Tucker, GA
National Provider Identifier
1255743670
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
HEALTHY MINDS PSYCHOLOGY ASSOCIATES INC
Practice address
3760 Lavista Rd Ste 102
Tucker, GA 30084-5622
Phone
(770) 375-8124
Fax
(770) 559-5543
NPI assigned
May 21, 2014
Last updated
Aug 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Devan N Isom
Title
Office Manger, Biller, Credentialin
Phone
(706) 888-5599

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Psychologist 103T00000X NU Primary
Cognitive & Behavioral Psychologist 103TB0200X NU
Clinical Psychologist 103TC0700X NU
Clinical Child & Adolescent Psychologist 103TC2200X NU
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
School Social Worker 1041S0200X NU

Addresses

Primary practice location

3760 Lavista Rd Ste 102
Tucker, GA 30084-5622

Mailing address

3760 Lavista Rd Ste 102
Tucker, GA 30084-5622
Phone (770) 375-8124

National Provider Directory

National Provider Directory

Locations

1479 Brockett Rd
Ste 100
Tucker, GA 30084
Phone (770) 375-8124

Practitioners & affiliated clinicians

Practitioners 6

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": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1255743670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 LAVISTA RD STE 102",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845622",
            "telephone_number": "770-375-8124",
            "fax_number": "770-559-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 LAVISTA RD STE 102",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845622",
            "telephone_number": "770-375-8124",
            "fax_number": "770-559-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY MINDS PSYCHOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-21",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "ISOM",
        "authorized_official_first_name": "DEVAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OFFICE MANGER, BILLER, CREDENTIALIN",
        "authorized_official_telephone_number": "706-888-5599"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.