Mindful Realizations Counseling & Consulting LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC007416 Issued in GA

Legal business name

MINDFUL REALIZATIONS COUNSELING & CONSULTING LLC

Practice address

901 Pavilion CT
McDonough, GA 30253-6665

Phone

(678) 814-4375

Fax

(770) 995-1959

NPI assigned

Nov 7, 2013

Organization subpart

No

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

Authorized official

Name

Tiffany Lynn Sullivan, LPCNPI 1093061285

Title

Owner

Phone

(678) 814-4375

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• Tiffany Lynn Sullivan, LPC

  • Professional Counselor
  • McDonough, GA
  • NPI 1093061285
  Medicare reassignment NPD Authorized official
• John Sullivan, LCSW

  • Professional Counselor
  • McDonough, GA
  • NPI 1275249112
  Medicare reassignment NPD

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699056000000",
    "number": "1295164549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PAVILION CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536665",
            "telephone_number": "678-814-4375",
            "fax_number": "770-995-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PAVILION CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536665",
            "telephone_number": "678-814-4375",
            "fax_number": "770-995-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL REALIZATIONS COUNSELING & CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-07",
        "last_updated": "2023-11-04",
        "certification_date": "2023-11-04",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-814-4375",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Michele Miller, PHARMD
• Victoria Miller, LPC
• Shelley Mills
• Tricia Mills, CADC II
• Mindful Milestones ABA LLC
• Mindrise, LLC
• Bryan Miner
• Regina Nicole Minor, FNP
• Miracles Start Here LLC
• Amina Mirza

• Professional Counselor in McDonough, GA
• Providers in McDonough, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.