Courtney Daniel Mims

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

5425 Peachtree Pkwy
Peachtree Corners, GA 30092-6536

Phone

(855) 850-0274

NPI assigned

Jul 2, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1306332416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 SAN REMO AVE",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925823099",
            "telephone_number": "909-709-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 PEACHTREE PKWY",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300926536",
            "telephone_number": "855-850-0274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "831 E Arrow Hwy",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917672535",
            "country_code": "US",
            "telephone_number": "909-398-4383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIMS",
        "first_name": "COURTNEY",
        "middle_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.