Mama Mentor LLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

Legal business name

MAMA MENTOR LLC

Practice address

175 Evergreen Dr
Martinez, GA 30907-1391

Phone

(706) 814-8083

NPI assigned

Feb 17, 2022

Organization subpart

No

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

Authorized official

Name

Candace Green, RLC, IBCLCNPI 1346910882

Title

RLC, Ibclc

Phone

(706) 814-8083

Specialties & licenses 1

Addresses

Practitioners 1

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

• Candace L Green, IBCLC

  • Lactation Consultant (Non-RN)
  • Augusta, GA
  • NPI 1346910882

  Lactation Consultant, Non-RN

  NPD Authorized official

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1275288391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EVERGREEN DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071391",
            "telephone_number": "706-814-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 EVERGREEN DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071391",
            "telephone_number": "706-814-8083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1245 Augusta West Pkwy",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309091807",
            "country_code": "US",
            "telephone_number": "706-868-0389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAMA MENTOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "RLC, IBCLC",
        "authorized_official_telephone_number": "706-814-8083",
        "authorized_official_credential": "RLC, IBCLC"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dadra Major, LMT
• Savannah Dawn Makowski, LMSW
• Holland Maness, DMD
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• Rajwinder S Manhiani, M.D.
• Tom Mar
• William Joseph Mareska, DDS

• Lactation Consultant (Non-RN) in Martinez, GA
• Providers in Martinez, GA by specialty
• Lactation Consultant (Non-RN) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.