Divine Behavioral Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DIVINE BEHAVIORAL SERVICES

Practice address

3781 Presidential Pkwy
Suite 110
Atlanta, GA 30340-3702

Phone

(770) 234-9667

Fax

(770) 234-9668

NPI assigned

Aug 26, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Jamaul Goddard

Title

Ceo

Phone

(770) 234-9667

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• One Community Behavioral Services Doing business as

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1427425495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3781 PRESIDENTIAL PKWY",
            "address_2": "SUITE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303403702",
            "telephone_number": "770-234-9667",
            "fax_number": "770-234-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3781 PRESIDENTIAL PKWY",
            "address_2": "SUITE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303403702",
            "telephone_number": "770-234-9667",
            "fax_number": "770-234-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "JAMAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-234-9667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003160059A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "One Community Behavioral Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diverse Counseling & Psychological Associates, LLC
• Diverse Images Management Services LLC,
• Henry Leon Diversi Jr., DMD MSD
• Diversity ABA
• Varada Dinkar Divgi, M.B.B.S. FAAP
• Divine Dermatology & Aesthetics LLC
• Divine Inclination Psychotherapy and Consulting, LLC
• Divine Intervention Behavioral Solutions LLC
• Divine Path Transit LLC
• Divine Therapy LLC

• Community/Behavioral Health Agency in Atlanta, GA
• Providers in Atlanta, 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 Aug 26, 2015; 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.