NPIMap

Organization Active NPI

Providence Residential & Outpatient PTSD Services (Props)

  • Mental Illness Community Based Residential Treatment Facility
  • Douglasville, GA
National Provider Identifier
1336480201
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES (PROPS)
Practice address
3400 Chapel Hill Rd
Suite 100 PMB #08
Douglasville, GA 30135-1739
Phone
(678) 882-5371
NPI assigned
Mar 1, 2013
Last updated
Mar 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Authorized official

Name
Dr. Felicia Berry-Mitchell, PHDNPI 1154420214
Title
President
Phone
(678) 882-5371

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

3400 Chapel Hill Rd
Suite 100 PMB #08
Douglasville, GA 30135-1739

Mailing address

PO Box 5464
Douglasville, GA 30154-0008
Phone (678) 882-5371

National Provider Directory

National Provider Directory
Tax ID family
Props2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1336480201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5464",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301540008",
            "telephone_number": "678-882-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CHAPEL HILL RD",
            "address_2": "SUITE 100 PMB #08",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351739",
            "telephone_number": "678-882-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE RESIDENTIAL & OUTPATIENT PTSD SERVICES (PROPS)",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "BERRY-MITCHELL",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-882-5371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.