Alice's Psychiatry & Wellness, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ALICE'S PSYCHIATRY & WELLNESS, LLC

Practice address

680 Hillcrest Rd NW Ste 400
Lilburn, GA 30047-6898

Phone

(404) 566-8045

Fax

(404) 999-6787

NPI assigned

Jan 15, 2024

Last updated

Aug 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Omoyeme Ehizuelen, PMHNP-BCNPI 1033844998

Title

Nurse Practitioner

Phone

(404) 566-8045

Specialties & licenses 1

Addresses

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.

• Omoyeme Aliceson Ehizuelen, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lilburn, GA
  • NPI 1033844998
  NPD Authorized official

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1407627805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NORTHSIDE DRIVE NW SUITE A7",
            "address_2": "PMB 2078",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30318",
            "telephone_number": "404-566-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 HILLCREST RD NW STE 400",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476898",
            "telephone_number": "404-566-8045",
            "fax_number": "404-999-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE'S PSYCHIATRY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "EHIZUELEN",
        "authorized_official_first_name": "OMOYEME",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "404-566-8045",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Lilburn, GA
• Providers in Lilburn, 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 Aug 7, 2024; 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.