Active NPI
PLM Metta Healing Oasis, LLC
- Clinical Psychologist
- Atlanta, GA
National Provider Identifier
1316385446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 003657
- Legal business name
- PLM METTA HEALING OASIS, LLC
- Practice address
- 920 Dannon VW SW Ste 3203
Atlanta, GA 30331-2161 - Phone
- (404) 590-8156
- Fax
- (206) 350-3122
- NPI assigned
- Jun 11, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pamela L. Jenkins, PHD
- Title
- Owner/Doctor
- Phone
- (404) 590-8156
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | PSY 003657 | GA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY 003657 | GA | |
| Clinical Psychologist | 103TC0700X | PSY 003657 | GA | Primary |
| Forensic Psychologist | 103TF0200X | PSY 003657 | GA |
Addresses
Primary practice location
920 Dannon VW SW Ste 3203
Atlanta, GA 30331-2161
Mailing address
920 Dannon VW SW Ste 3203
Atlanta, GA 30331-2161
Phone (404) 590-8156
National Provider Directory
National Provider DirectoryLocations
920 Dannon Vw SW
Ste 3203
Atlanta, GA 30331
Phone (404) 590-8156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370908800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1614124800000",
"number": "1316385446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 DANNON VW SW STE 3203",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303312161",
"telephone_number": "404-590-8156",
"fax_number": "206-350-3122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 DANNON VW SW STE 3203",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303312161",
"telephone_number": "404-590-8156",
"fax_number": "206-350-3122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLM METTA HEALING OASIS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-06-11",
"last_updated": "2021-02-24",
"certification_date": "2021-02-24",
"status": "A",
"authorized_official_last_name": "JENKINS",
"authorized_official_first_name": "PAMELA",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "OWNER/DOCTOR",
"authorized_official_telephone_number": "404-590-8156",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "GA",
"license": "PSY 003657",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "GA",
"license": "PSY 003657",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY 003657",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Forensic",
"state": "GA",
"license": "PSY 003657",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.