Molding Passionate Active Creative Kids Corporation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MOLDING PASSIONATE ACTIVE CREATIVE KIDS CORPORATION

Practice address

302 N Park St
Carrollton, GA 30117-3056

Phone

(678) 849-4656

NPI assigned

Apr 5, 2024

Last updated

Nov 6, 2025By 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

Demarcus Devon Copelannd, C.L.C

Title

Founder and Program Director

Phone

(678) 849-4656

Specialties & licenses 4

Addresses

Other names 1

• M-PACK Other name

Locations

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1417700972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 N PARK ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173056",
            "telephone_number": "678-849-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N PARK ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173056",
            "telephone_number": "678-849-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLDING PASSIONATE ACTIVE CREATIVE KIDS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "COPELANND",
        "authorized_official_first_name": "DEMARCUS",
        "authorized_official_middle_name": "DEVON",
        "authorized_official_title_or_position": "FOUNDER AND PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "678-849-4656",
        "authorized_official_credential": "C.L.C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M-PACK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kadie Michelle Mitchell, PT, DPT
• Patricia Mitchell
• Juliet Njideka Mkpuechina
• Jeremiah Mobley, MBID, ATC
• Callie Chaffe Mohn, DC
• Catherine Daniel Moncayo, PT
• Chelsea Marie Monroy, FNP-C
• Carolyn Sue Moore
• Joshua David Moore, MA, APC
• Alexandre Morin, MD

• Community/Behavioral Health Agency in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.