Organization Active NPI

PLM Metta Healing Oasis, LLC

  • Clinical Psychologist
  • Atlanta, GA
National Provider Identifier
1316385446
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 003657 Issued in GA
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

Updated by the provider on Feb 24, 2021

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)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TA0400X PSY 003657 GA
Cognitive & Behavioral PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TB0200X PSY 003657 GA
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PSY 003657 GA Primary
Forensic PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.