Urban Wellness, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

URBAN WELLNESS, LLC

Practice address

3070 N Main St NW
Kennesaw, GA 30144-2756

Phone

(770) 285-7321

Fax

(770) 285-7619

NPI assigned

Aug 12, 2021

Organization subpart

No

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

Authorized official

Name

Erica Michelle Grant, LCSWNPI 1801170402

Title

Owner

Phone

(770) 285-7321

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.

• Erica Michelle Grant, LCSW

  • Clinical Social Worker
  • Kennesaw, GA
  • NPI 1801170402
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1326713231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N MAIN ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442756",
            "telephone_number": "770-285-7321",
            "fax_number": "770-285-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N MAIN ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442756",
            "telephone_number": "770-285-7321",
            "fax_number": "770-285-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-285-7321",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Underwood, NP
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• Laura Uphouse, CRNA
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• Olivia V Urling
• Patsy Usberghi
• Swapna Vacha
• Conrad Valcy, LAPC
• Alisha T Valdez, PHARMD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.