Mindful Journeys Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDFUL JOURNEYS COUNSELING LLC

Practice address

3949 Holcomb Bridge Rd Ste 200
Peachtree Corners, GA 30092-2208

Phone

(404) 369-3985

NPI assigned

Nov 20, 2021

Last updated

Jan 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob Michael Sobel, LCSWNPI 1053950097

Title

Owner/Psychotherapist

Phone

(404) 369-3985

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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.

• Jacob Sobel, LCSW

  • Clinical Social Worker
  • Peachtree Corners, GA
  • NPI 1053950097

  Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1637366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1295492684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 HIGHCROFT CIR",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924964",
            "telephone_number": "678-923-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 HOLCOMB BRIDGE RD STE 200",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300922208",
            "telephone_number": "404-369-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL JOURNEYS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-20",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "SOBEL",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "404-369-3985",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1053950097",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Meeks, PHARMD
• Sara Gheesling Melito, LPC
• Mary Mendelson
• Alan Brad Miller, M.D.
• Courtney Daniel Mims
• Mindful Stages
• Modern Wellness Collective
• Suzana Mara Montana, M.D.
• Alexander Wyckoff Moore, DC, IVCA CERT
• Emmanuel Moore, PHARMD

• Clinical Social Worker in Peachtree Corners, GA
• Providers in Peachtree Corners, 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 Jan 11, 2022; 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.