Balanced Mind Behavioral Health

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BALANCED MIND BEHAVIORAL HEALTH

Practice address

320 Lanier Ave W Ste 200
Fayetteville, GA 30214-7443

Phone

(470) 516-4399

NPI assigned

Apr 10, 2025

Organization subpart

No

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

Authorized official

Name

Priscilla MaxwellNPI 1881460509

Title

Owner

Phone

(470) 516-4399

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Priscilla Maxwell

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, GA
  • NPI 1881460509
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1316732522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 LANIER AVE W STE 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 LANIER AVE W STE 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147443",
            "telephone_number": "470-516-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED MIND BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-516-4399"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Bailey, RBT
• Courtney Mels Bailey, NP
• Elizabeth Baker, RBT
• Susan Stooksbury Baker, PT, MS
• Balance Ground Counseling LLC
• Senthil Surya Balasubramanian, MD
• Ralph Waldo Balchin Jr., PHARMACIST
• Halimatou Balde, RBT
• Laura Baldwin, PT, DPT
• Virginia Lynn Balkcom

• Psychiatric/Mental Health Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.